MEDICARE: SARINA HEALTHCARE LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831774264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARINA HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	68 WINDSOR RD
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02445-1335
Country	:	US
Telephone Number	:	617-319-2914
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 BEVILLE RD
Second Line	:
City	:	SOUTH DAYTONA
State	:	FL
Zip	:	32119-1705
Country	:	US
Telephone Number	:	386-767-9000
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JAMSHED KHAN
Credential	:
Telephone Number	:	386-767-9000

Provider Enumeration Date	:	03/17/2021
Last Update Date	:	03/17/2021

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Directions to “SARINA HEALTHCARE LLC ” Practice Location

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