Provider Demographics
NPI:1578693305
Name:BLUM, SARA M (PA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:BLUM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:4725 N FEDERAL HIGHWAY
Mailing Address - Street 2:ORTHOPAEDIC CENTER
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-958-4800
Mailing Address - Fax:954-958-4899
Practice Address - Street 1:9960 CENTRAL PARK BLVD N STE 150A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1760
Practice Address - Country:US
Practice Address - Phone:561-922-9112
Practice Address - Fax:561-367-5399
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104058363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9104058OtherMEDICAL LICENSE