MEDICARE: SARA AZER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1528878113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA AZER

Provider Business Mailing Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 210
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3199
Country	:	US
Telephone Number	:	571-261-1234
Fax Number	:

Provider Business Practice Location Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 210
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3199
Country	:	US
Telephone Number	:	571-261-1234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	06/02/2026

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Directions to “ SARA AZER ” Practice Location

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