MEDICARE: SARAH E. WALDROP R.N. ,CRNFA

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	163W00000X	Registered Nurse	24602-2	FL

General Provider Information

NPI Number	:	1700875291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH E. WALDROP R.N. ,CRNFA

Provider Business Mailing Address
First Line	:	3450 E ORANGE AVE
Second Line	:
City	:	EUSTIS
State	:	FL
Zip	:	32736-2236
Country	:	US
Telephone Number	:	352-357-0291
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WATERMAN WAY
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-5266
Country	:	US
Telephone Number	:	352-253-3333
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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