Healthcare Provider Details

I. General information

NPI: 1093601973
Provider Name (Legal Business Name): SARAH GANLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 SW 1ST ST
MIAMI FL
33135-2202
US

IV. Provider business mailing address

3880 BIRD RD APT 810
MIAMI FL
33146-1546
US

V. Phone/Fax

Practice location:
  • Phone: 305-541-3400
  • Fax:
Mailing address:
  • Phone: 786-540-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: