Healthcare Provider Details

I. General information

NPI: 1376450643
Provider Name (Legal Business Name): SARA ELIZABETH MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 HOSPITAL PKWY
JOHNS CREEK GA
30097-5775
US

IV. Provider business mailing address

16678 SHELL BAY DR
LAND O LAKES FL
34638-5750
US

V. Phone/Fax

Practice location:
  • Phone: 678-474-7000
  • Fax:
Mailing address:
  • Phone: 813-952-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: