Healthcare Provider Details

I. General information

NPI: 1447166798
Provider Name (Legal Business Name): SARAH FERTIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E MOWRY DR
HOMESTEAD FL
33030-8141
US

IV. Provider business mailing address

810 E MOWRY DR APT 523
HOMESTEAD FL
33030-8145
US

V. Phone/Fax

Practice location:
  • Phone: 786-884-9115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberCNA494467
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: