Provider Demographics
NPI:1750057568
Name:RASMUSSEN, SARA JEAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:JEAN
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 FORT CLARKE BLVD APT 803
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7131
Mailing Address - Country:US
Mailing Address - Phone:386-334-2668
Mailing Address - Fax:
Practice Address - Street 1:1415 FORT CLARKE BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7181
Practice Address - Country:US
Practice Address - Phone:352-554-4757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT37629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist