Provider Demographics
NPI:1366591398
Name:BROWN, SARA KRISTINE (LMP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:KRISTINE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 SW 10TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2560
Mailing Address - Country:US
Mailing Address - Phone:360-789-4731
Mailing Address - Fax:
Practice Address - Street 1:242 SW 10TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2560
Practice Address - Country:US
Practice Address - Phone:360-789-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA102454225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist