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General NPI Number Information
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NPI Number | 1245636646
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Entity Type | Individual
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Provider Name | SARAH NIEDZWIECKI ATC
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Gender | Female
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1150 CAMPO SANO AVE
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City | CORAL GABLES
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State | FL
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Zip | 33146-1100
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Country | US
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Telephone | 786-268-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 8255 SW 72ND CT UNIT E531
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City | MIAMI
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State | FL
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Zip | 33143-4255
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Country | US
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Telephone |
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 096.003836
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL4380
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License Number State | FL
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