Provider Demographics
NPI:1427552934
Name:GIACCHETTA, SARA (PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:GIACCHETTA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:10141 BIG BEND RD STE 101
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-7419
Practice Address - Country:US
Practice Address - Phone:813-397-1270
Practice Address - Fax:813-397-1271
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY021917363A00000X
FLPA9117297363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant