MEDICARE: MRS. SARA BUNLOETH SAY SMITH ARNP

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	363LF0000X	Family Nurse Practitioner	663776	FL

General Provider Information

NPI Number	:	1912607334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA BUNLOETH SAY SMITH ARNP

Provider Business Mailing Address
First Line	:	1905 W BUSCH BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-7675
Country	:	US
Telephone Number	:	813-365-3525
Fax Number	:	813-435-3304

Provider Business Practice Location Address
First Line	:	517 BUENA VISTA ST
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4504
Country	:	US
Telephone Number	:	863-648-4275
Fax Number	:

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

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	11/01/2025

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