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NPI Code Detail

MEDICARE: LUANNE GRAVANO SADOWSKY APRN

MEDICARE: LUANNE GRAVANO SADOWSKY APRN
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
1363LG0600XGerontology Nurse PractitionerAPRN9217373FL
2363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN9217373FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y080JOTHERFLBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508832312
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUANNE GRAVANO SADOWSKY APRN
Provider Business Mailing Address
First Line : PO BOX 1559
Second Line :
City : BARTOW
State : FL
Zip : 33831-1559
Country : US
Telephone Number : 863-519-0575
Fax Number : 866-582-9251
Provider Business Practice Location Address
First Line : 1835 GILMORE AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3017
Country : US
Telephone Number : 863-519-0575
Fax Number : 863-582-9251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 12/26/2024

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