Healthcare Provider Details

I. General information

NPI: 1659320844
Provider Name (Legal Business Name): SARA E YERMAL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S FLORIDA ST
BUSHNELL FL
33513-6703
US

IV. Provider business mailing address

2881 S BUMBY AVE
ORLANDO FL
32806-8704
US

V. Phone/Fax

Practice location:
  • Phone: 352-793-2441
  • Fax:
Mailing address:
  • Phone: 407-894-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP1526802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: