Healthcare Provider Details

I. General information

NPI: 1053229765
Provider Name (Legal Business Name): SARAH KATHLEEN MINASIAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 OLD BAINBRIDGE RD
TALLAHASSEE FL
32303-5340
US

IV. Provider business mailing address

3197 ROBINSON OAK DR
TALLAHASSEE FL
32303-2417
US

V. Phone/Fax

Practice location:
  • Phone: 850-404-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9408200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: