Healthcare Provider Details

I. General information

NPI: 1295586097
Provider Name (Legal Business Name): MISS MORGAN ELIZABETH SARAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 S KINGS AVE
BRANDON FL
33511-6048
US

IV. Provider business mailing address

10306 HENRY MORGAN LN
THONOTOSASSA FL
33592-8310
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-3750
  • Fax: 813-939-3844
Mailing address:
  • Phone: 904-868-8601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9121951
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: