Provider Demographics
NPI:1619146834
Name:VINCI, SARA R (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:R
Last Name:VINCI
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 7TH AVE S
Mailing Address - Street 2:J. DENNIS SEXTON BUILDING
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4820
Mailing Address - Country:US
Mailing Address - Phone:727-767-8099
Mailing Address - Fax:727-767-8847
Practice Address - Street 1:500 7TH AVE S
Practice Address - Street 2:J. DENNIS SEXTON BUILDING
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4820
Practice Address - Country:US
Practice Address - Phone:727-767-8099
Practice Address - Fax:727-767-8847
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTT13090174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist