MEDICARE: MS. SARAH CRULL 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
1	207N00000X	Dermatology Physician	APRN11044639	FL

General Provider Information

NPI Number	:	1902763436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARAH CRULL APRN

Provider Business Mailing Address
First Line	:	5301 4TH AVENUE CIR E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-5623
Country	:	US
Telephone Number	:	941-761-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 4TH AVENUE CIR E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-5623
Country	:	US
Telephone Number	:	941-761-2900
Fax Number	:

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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