MEDICARE: SARAH CATHERINE HRYZAK D.O.

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	207RN0300X	Nephrology Physician	OS21083	FL
2	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942704648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH CATHERINE HRYZAK D.O.

Provider Business Mailing Address
First Line	:	2 SHIRCLIFF WAY
Second Line	:	SUITE 700 DEPAUL BLDG
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204
Country	:	US
Telephone Number	:	904-389-5333
Fax Number	:	904-389-5332

Provider Business Practice Location Address
First Line	:	13241 BARTRAM PARK BLVD
Second Line	:	SUITE 1509
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-1626
Country	:	US
Telephone Number	:	904-389-5333
Fax Number	:	904-389-5352

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

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	10/22/2024

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