Healthcare Provider Details

I. General information

NPI: 1407554090
Provider Name (Legal Business Name): SARAH HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 BLAKE PLEDGER CT
NORTH FORT MYERS FL
33917-8228
US

IV. Provider business mailing address

6750 BLAKE PLEDGER CT
NORTH FORT MYERS FL
33917-8228
US

V. Phone/Fax

Practice location:
  • Phone: 239-247-0499
  • Fax:
Mailing address:
  • Phone: 239-247-0499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-83813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: