Healthcare Provider Details

I. General information

NPI: 1295601391
Provider Name (Legal Business Name): BLADDER INSTITUTE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 ROLLING ACRES RD
LADY LAKE FL
32159-5047
US

IV. Provider business mailing address

16912 W PHIL C PETERS RD
WINTER GARDEN FL
34787-9328
US

V. Phone/Fax

Practice location:
  • Phone: 407-342-5842
  • Fax:
Mailing address:
  • Phone: 407-342-5842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD JEFFERY SAPP
Title or Position: CEO
Credential:
Phone: 352-745-7202