Provider Demographics
NPI:1003109661
Name:ARMSTRONG, SANDRA L (ARPN)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:ARPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-312-3462
Mailing Address - Fax:
Practice Address - Street 1:1810 ELDRON BLVD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-3290
Practice Address - Country:US
Practice Address - Phone:321-312-3462
Practice Address - Fax:321-409-6812
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN218482363L00000X
FLAPRN9128482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFF532XOtherMEDICARE