Provider Demographics
NPI:1578241162
Name:RASOOL, SAARA (DMD)
Entity Type:Individual
Prefix:
First Name:SAARA
Middle Name:
Last Name:RASOOL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3054
Mailing Address - Country:US
Mailing Address - Phone:407-484-4847
Mailing Address - Fax:
Practice Address - Street 1:2063 ALOMA AVE STE 203
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3319
Practice Address - Country:US
Practice Address - Phone:407-673-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist