Healthcare Provider Details

I. General information

NPI: 1467629097
Provider Name (Legal Business Name): SARA GOULD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-1801
US

IV. Provider business mailing address

1717 6TH AVE S
BIRMINGHAM AL
35233-1801
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME174644
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number33305
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License NumberME174644
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: