Provider Demographics
NPI:1578943049
Name:TUGUTA, SANDRIA ALATHIA (APRN)
Entity Type:Individual
Prefix:
First Name:SANDRIA
Middle Name:ALATHIA
Last Name:TUGUTA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:661 E ALTAMONTE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5102
Mailing Address - Country:US
Mailing Address - Phone:407-303-5191
Mailing Address - Fax:407-303-5193
Practice Address - Street 1:1925 MIZELL AVE STE 201
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4155
Practice Address - Country:US
Practice Address - Phone:407-303-2615
Practice Address - Fax:407-303-5193
Is Sole Proprietor?:No
Enumeration Date:2015-05-31
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9288077363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily