Provider Demographics
NPI:1376099697
Name:GRAHAM-MCCALL, SARAH LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:GRAHAM-MCCALL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18242 AUTUMN LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8435
Mailing Address - Country:US
Mailing Address - Phone:352-650-2997
Mailing Address - Fax:
Practice Address - Street 1:10521 HEARTH RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3714
Practice Address - Country:US
Practice Address - Phone:352-650-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9109508363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant