Provider Demographics
NPI:1164752713
Name:SILVEIRA, SARAH JANE FELLENZ (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE FELLENZ
Last Name:SILVEIRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:FELLENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARPN
Mailing Address - Street 1:PO BOX 690609
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32869-0609
Mailing Address - Country:US
Mailing Address - Phone:407-846-7546
Mailing Address - Fax:321-206-5419
Practice Address - Street 1:7932 W SAND LAKE RD
Practice Address - Street 2:202
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7263
Practice Address - Country:US
Practice Address - Phone:407-846-7546
Practice Address - Fax:321-206-5419
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4343363LA2200X
FLARNP9171914363L00000X
FLAPRN9171914363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIL768ZMedicare PIN
FLIL768YMedicare PIN