Provider Demographics
NPI:1831300201
Name:SADLER, RENA ELIZABETH
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:ELIZABETH
Last Name:SADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12229 WINDRIVER LN
Mailing Address - Street 2:UNIT #9
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12120 MOON LAKE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-1809
Practice Address - Country:US
Practice Address - Phone:727-856-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL210119117707940183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician