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NPI Code Detail

MEDICARE: SARA JANE CARLSON

MEDICARE: SARA JANE CARLSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS46402FL

General Provider Information

NPI Number : 1184961104
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA JANE CARLSON
Provider Business Mailing Address
First Line : 1501 MEETING PL
Second Line :
City : ORLANDO
State : FL
Zip : 32814-6602
Country : US
Telephone Number : 407-897-7373
Fax Number :
Provider Business Practice Location Address
First Line : 1501 MEETING PL
Second Line :
City : ORLANDO
State : FL
Zip : 32814-6602
Country : US
Telephone Number : 407-897-7373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2013
Last Update Date : 01/10/2013

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Directions to “ SARA JANE CARLSON ” Practice Location

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