Healthcare Provider Details

I. General information

NPI: 1982807194
Provider Name (Legal Business Name): SALLY BETHART ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-7516
US

IV. Provider business mailing address

224 SE 24TH ST
GAINESVILLE FL
32641-7516
US

V. Phone/Fax

Practice location:
  • Phone: 352-294-8478
  • Fax:
Mailing address:
  • Phone: 352-334-7917
  • Fax: 352-955-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP3093752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: