MEDICARE: DR. STEPHANIE SARKODIE PSYD

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
1	103TC0700X	Clinical Psychologist	PY12835	FL
2	106H00000X	Marriage & Family Therapist	MT4469	FL

General Provider Information

NPI Number	:	1700663556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE SARKODIE PSYD

Provider Business Mailing Address
First Line	:	PO BOX 46873
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33646-0108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5242 ROYAL CYPRESS CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-5053
Country	:	US
Telephone Number	:	267-597-2193
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2023
Last Update Date	:	07/05/2025

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