Provider Demographics
NPI:1134901465
Name:CARACOSTAS, SARA ROSE (APRN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ROSE
Last Name:CARACOSTAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519A E BLOOMINGDALE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8105
Mailing Address - Country:US
Mailing Address - Phone:813-655-4100
Mailing Address - Fax:813-655-1775
Practice Address - Street 1:519A E BLOOMINGDALE AVE STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8105
Practice Address - Country:US
Practice Address - Phone:813-655-4100
Practice Address - Fax:813-655-1775
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily