Healthcare Provider Details

I. General information

NPI: 1275202574
Provider Name (Legal Business Name): SARAH YVETTE SANCHEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 JAN LAN BLVD
SAINT CLOUD FL
34772-3477
US

IV. Provider business mailing address

1955 JAN LAN BLVD
SAINT CLOUD FL
34772-8861
US

V. Phone/Fax

Practice location:
  • Phone: 407-791-0613
  • Fax:
Mailing address:
  • Phone: 407-791-0613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number11015317
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number11015317
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11015317
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number11015317
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11015317
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: