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General NPI Number Information
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NPI Number | 1629079520
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Entity Type | Individual
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Provider Name | SARA ANN BOHN D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 105 ARNESON AVE
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City | AUBURNDALE
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State | FL
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Zip | 33823-3229
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Country | US
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Telephone | 863-393-6404
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Fax | 863-583-3118
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Provider Business Mailing Address
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Address Line | 423 PALASTRO AVE
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City | AUBURNDALE
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State | FL
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Zip | 33823-8704
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Country | US
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Telephone | 573-353-8008
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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 | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 36976
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36976
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS13725
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License Number State | FL
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