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General NPI Number Information
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NPI Number | 1174305692
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Entity Type | Individual
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Provider Name | SARAH N BENNETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 2893 ENTERPRISE RD STE 100
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City | DEBARY
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State | FL
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Zip | 32713-2784
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Country | US
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Telephone | 866-400-3376
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Fax | 386-789-0219
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Provider Business Mailing Address
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Address Line | 151 SOUTHHALL LN STE 300
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City | MAITLAND
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State | FL
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Zip | 32751-7172
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Country | US
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Telephone | 866-400-3376
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Fax | 407-650-3455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9118066
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License Number State | FL
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