Provider Demographics
NPI:1164706065
Name:STRUNK, SARAH B (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:B
Last Name:STRUNK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:B
Other - Last Name:GRAVAGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-844-4800
Mailing Address - Fax:813-844-1103
Practice Address - Street 1:10909 W LINEBAUGH AVE STE 101
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1741
Practice Address - Country:US
Practice Address - Phone:813-844-4800
Practice Address - Fax:813-844-1103
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007331800Medicaid
FLU5872ZMedicare UPIN
FL007331800Medicaid
FLFZ425YMedicare PIN