Provider Demographics
NPI:1497294979
Name:MARINO, SARAH JEANNETTE (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:JEANNETTE
Last Name:MARINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JEANNETTE
Other - Last Name:MANNERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1890 LPGA BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-7138
Mailing Address - Country:US
Mailing Address - Phone:386-252-4701
Mailing Address - Fax:386-253-9410
Practice Address - Street 1:1890 LPGA BLVD STE 160
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-7138
Practice Address - Country:US
Practice Address - Phone:386-252-4701
Practice Address - Fax:386-253-9410
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026221207V00000X
FLOS18865207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology