MEDICARE: SARAH BRYCE

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	103K00000X	Behavior Analyst

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982097960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BRYCE

Provider Business Mailing Address
First Line	:	409 E OAKLAND AVE
Second Line	:	STE B
City	:	OAKLAND
State	:	FL
Zip	:	34787-3070
Country	:	US
Telephone Number	:	352-978-3045
Fax Number	:

Provider Business Practice Location Address
First Line	:	365 CITRUS TOWER BLVD STE 106
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6532
Country	:	US
Telephone Number	:	352-223-1999
Fax Number	:	352-600-3119

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

Provider Enumeration Date	:	03/14/2015
Last Update Date	:	01/16/2019

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Directions to “ SARAH BRYCE ” Practice Location

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