Provider Demographics
NPI:1629599030
Name:BERTRAND, SARA GRACE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SARA GRACE
Middle Name:
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 CRANES ROOST BLVD STE 2060
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-3489
Mailing Address - Country:US
Mailing Address - Phone:407-949-0222
Mailing Address - Fax:
Practice Address - Street 1:155 CRANES ROOST BLVD STE 2060
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3489
Practice Address - Country:US
Practice Address - Phone:407-949-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9314228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner