Healthcare Provider Details

I. General information

NPI: 1417537440
Provider Name (Legal Business Name): SARAH MILONE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 1006
ST AUGUSTINE FL
32086-3702
US

IV. Provider business mailing address

2862 GRANDE OAKS WAY
FLEMING ISLAND FL
32003-3767
US

V. Phone/Fax

Practice location:
  • Phone: 904-794-7050
  • Fax:
Mailing address:
  • Phone: 904-728-2435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11012320
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: