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General NPI Number Information
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NPI Number | 1356907687
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Entity Type | Individual
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Provider Name | SARAH BOU NADER M.D
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Gender | Female
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 1801 US HIGHWAY 441
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City | LEESBURG
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State | FL
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Zip | 34748-2545
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Country | US
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Telephone | 352-460-4004
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Fax | 352-460-4003
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Provider Business Mailing Address
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Address Line | 1801 US HIGHWAY 441
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City | LEESBURG
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State | FL
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Zip | 34748-2545
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Country | US
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Telephone | 352-460-4004
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Fax | 352-460-4003
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME156843
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License Number State | FL
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