Provider Demographics
NPI:1194042366
Name:NOTTER, SARAH A (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:A
Last Name:NOTTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8839 BRYAN DAIRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1207
Mailing Address - Country:US
Mailing Address - Phone:727-394-5650
Mailing Address - Fax:813-635-7939
Practice Address - Street 1:8839 BRYAN DAIRY RD STE 200
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1207
Practice Address - Country:US
Practice Address - Phone:727-394-5650
Practice Address - Fax:813-635-7939
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119187208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012958900Medicaid
FLHW764ZMedicare PIN