Provider Demographics
NPI:1396077210
Name:OLIVER, SARAH (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5000 W OAKLAND PARK BLVD
Mailing Address - Street 2:FLORIDA MEDICAL CENTER
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:561-967-6500
Mailing Address - Fax:561-433-4175
Practice Address - Street 1:4801 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4746
Practice Address - Country:US
Practice Address - Phone:561-967-6500
Practice Address - Fax:561-433-4175
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20000008982255A2300X
09-1124246Z00000X
FLPA9107486363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
1113815OtherNATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
2000000898OtherBOARD OF CERTIFICATION, INC.
09-1124OtherNATIONAL BOARD FOR CERTIFICATION OF ORTHOPAEDIC TECHNOLOGISTS
2000000898OtherBOARD OF CERTIFICATION, INC.