Provider Demographics
NPI:1437745148
Name:TATE, SADIE MONET (LM, CPM)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:MONET
Last Name:TATE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 LANTANA DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-2464
Mailing Address - Country:US
Mailing Address - Phone:407-450-9799
Mailing Address - Fax:
Practice Address - Street 1:1304 VIBURNUM LN
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2453
Practice Address - Country:US
Practice Address - Phone:321-527-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL394176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife