Healthcare Provider Details

I. General information

NPI: 1265308605
Provider Name (Legal Business Name): SARA AURORA ORTIZ-MARREROS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S
SAINT PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

1418 50TH AVE N
SAINT PETERSBURG FL
33703-3546
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 949-374-0570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9502719
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: