Healthcare Provider Details

I. General information

NPI: 1578479044
Provider Name (Legal Business Name): SARA YASO KAHANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 SW 39TH ST
WEST PARK FL
33023-6254
US

IV. Provider business mailing address

3801 SW 39TH ST
WEST PARK FL
33023-6254
US

V. Phone/Fax

Practice location:
  • Phone: 786-499-4673
  • Fax:
Mailing address:
  • Phone: 786-499-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11050223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: