Basic Information
Provider Information
NPI: 1609029792
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEFKOWITZ
FirstName: SARA
MiddleName: MELISSA
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2850 WHISPERING DR S
Address2:  
City: LARGO
State: FL
PostalCode: 337713868
CountryCode: US
TelephoneNumber: 7273659235
FaxNumber:  
Practice Location
Address1: 801 6TH ST S
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337014816
CountryCode: US
TelephoneNumber: 8004564543
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/03/2008
LastUpdateDate: 11/03/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XARNP9200051FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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