Provider Demographics
NPI:1750566204
Name:YAGELSKI, SARAH ANN (MS/OTR/L)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:YAGELSKI
Suffix:
Gender:F
Credentials:MS/OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18344 MURDOCK CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1008
Mailing Address - Country:US
Mailing Address - Phone:941-625-6547
Mailing Address - Fax:941-629-6415
Practice Address - Street 1:18344 MURDOCK CIR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1008
Practice Address - Country:US
Practice Address - Phone:941-625-6547
Practice Address - Fax:941-629-6415
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00847901OtherRAILROAD MEDICARE
FLZ03JYOtherBLUE CROSS BLUE SHIELD