Provider Demographics
NPI:1508832312
Name:SADOWSKY, LUANNE GRAVANO (ARNP)
Entity Type:Individual
Prefix:
First Name:LUANNE
Middle Name:GRAVANO
Last Name:SADOWSKY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 SILVER LEAF LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2933
Mailing Address - Country:US
Mailing Address - Phone:863-393-4703
Mailing Address - Fax:
Practice Address - Street 1:6207 SILVER LEAF LN
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2933
Practice Address - Country:US
Practice Address - Phone:863-393-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9217373363LG0600X
FLARNP9217373363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY080JOtherBLUE CROSS BLUE SHIELD
FL307013100Medicaid
FLR40807Medicare UPIN
FLU3882RMedicare PIN