Healthcare Provider Details

I. General information

NPI: 1538074109
Provider Name (Legal Business Name): SARA NEWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 SOUTH ST
FERN PARK FL
32730-2252
US

IV. Provider business mailing address

402 SOUTH ST
FERN PARK FL
32730-2252
US

V. Phone/Fax

Practice location:
  • Phone: 407-375-6070
  • Fax:
Mailing address:
  • Phone: 407-375-6070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11050084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: