MEDICARE: SARAH VENDEL MERRIWETHER

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1780419150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH VENDEL MERRIWETHER

Provider Business Mailing Address
First Line	:	2147 MORNING SUN LN
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3329
Country	:	US
Telephone Number	:	239-250-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	2147 MORNING SUN LN
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3329
Country	:	US
Telephone Number	:	239-250-1332
Fax Number	:

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	09/09/2024

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