Healthcare Provider Details

I. General information

NPI: 1558717090
Provider Name (Legal Business Name): SARA AL NOOH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21216 WAYMOUTH RUN
ESTERO FL
33928-3243
US

IV. Provider business mailing address

21216 WAYMOUTH RUN
ESTERO FL
33928-3243
US

V. Phone/Fax

Practice location:
  • Phone: 238-826-5404
  • Fax:
Mailing address:
  • Phone: 239-737-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT23799
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: