Healthcare Provider Details

I. General information

NPI: 1144068750
Provider Name (Legal Business Name): SARAH LAKADAWALA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 TAMPA RD STE C
PALM HARBOR FL
34683-5849
US

IV. Provider business mailing address

1126 59TH AVE N
ST PETERSBURG FL
33703-1128
US

V. Phone/Fax

Practice location:
  • Phone: 727-787-2092
  • Fax: 833-941-2542
Mailing address:
  • Phone: 210-391-0558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11034229
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: