Provider Demographics
NPI:1780650242
Name:RHODES, SARA TRACY (MD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:TRACY
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5474 LAKE HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1036
Mailing Address - Country:US
Mailing Address - Phone:407-679-3400
Mailing Address - Fax:407-679-3412
Practice Address - Street 1:5474 LAKE HOWELL RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1036
Practice Address - Country:US
Practice Address - Phone:407-679-3400
Practice Address - Fax:407-679-3412
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14498OtherBLUE CROSS BLUE SHIELD
FL7677501OtherAETNA
FL7677501OtherAETNA
FL14498OtherBLUE CROSS BLUE SHIELD