Provider Demographics
NPI:1689132086
Name:GENDRIZ, SARAI
Entity type:Individual
Prefix:
First Name:SARAI
Middle Name:
Last Name:GENDRIZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19101 SW 108TH AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6783
Mailing Address - Country:US
Mailing Address - Phone:305-680-1308
Mailing Address - Fax:305-842-5295
Practice Address - Street 1:19101 SW 108TH AVE UNIT 4
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6783
Practice Address - Country:US
Practice Address - Phone:305-680-1308
Practice Address - Fax:305-842-5295
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001252363LP0808X
FL11001252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health