Provider Demographics
NPI:1730628447
Name:NASH, SARAH (LAT, ATC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NASH
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 NW 88TH ST
Mailing Address - Street 2:#212
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10600 NW 88TH ST
Practice Address - Street 2:#212
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3458
Practice Address - Country:US
Practice Address - Phone:704-497-3684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL45672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer