Provider Demographics
NPI:1346518826
Name:SARA S. TURSE M.D.P.A.
Entity Type:Organization
Organization Name:SARA S. TURSE M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:TURSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-733-1111
Mailing Address - Street 1:200 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3100
Mailing Address - Country:US
Mailing Address - Phone:321-733-1111
Mailing Address - Fax:321-733-1114
Practice Address - Street 1:200 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3100
Practice Address - Country:US
Practice Address - Phone:321-733-1111
Practice Address - Fax:321-733-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1972822559OtherNPI 1
FL07569Medicare UPIN