Healthcare Provider Details

I. General information

NPI: 1639855562
Provider Name (Legal Business Name): SARA ADRADOS DNP, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 5TH AVE
INDIALANTIC FL
32903-3176
US

IV. Provider business mailing address

230 5TH AVE
INDIALANTIC FL
32903-3176
US

V. Phone/Fax

Practice location:
  • Phone: 321-723-7353
  • Fax:
Mailing address:
  • Phone: 321-723-7353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11027170
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: