Provider Demographics
NPI:1629079520
Name:BOHN, SARA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ANN
Last Name:BOHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 PALASTRO AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-8704
Mailing Address - Country:US
Mailing Address - Phone:573-353-8008
Mailing Address - Fax:
Practice Address - Street 1:105 ARNESON AVE
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-3229
Practice Address - Country:US
Practice Address - Phone:863-393-6404
Practice Address - Fax:863-583-3118
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2021-07-01
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
MO36976173000000X, 207Q00000X
FLOS13725207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0104183OtherUNITED HEALTH CARE
MO080183733OtherMEDICARE RAILROAD
MO242866655Medicaid
MO16644OtherBLUE CROSS BLUE SHIELD
MO4251694OtherAETNA
MO194082OtherHEALTH LINK
MO329775572Medicare PIN
MO4251694OtherAETNA
MOE66051Medicare UPIN