Healthcare Provider Details

I. General information

NPI: 1417287152
Provider Name (Legal Business Name): BRANDI SADLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 12/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 NW 97TH BLVD
GAINESVILLE FL
32606-3742
US

IV. Provider business mailing address

814 NW 11TH AVE
GAINESVILLE FL
32601-4149
US

V. Phone/Fax

Practice location:
  • Phone: 352-283-6760
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMA45066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: