Provider Demographics
NPI:1336892322
Name:SARA MURRAY
Entity Type:Organization
Organization Name:SARA MURRAY
Other - Org Name:NUTRITION SARA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CSR
Authorized Official - Phone:904-806-3067
Mailing Address - Street 1:817 N ALEXANDER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-4819
Mailing Address - Country:US
Mailing Address - Phone:904-806-3067
Mailing Address - Fax:
Practice Address - Street 1:817 N ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-4819
Practice Address - Country:US
Practice Address - Phone:904-806-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty