Provider Demographics
NPI:1811641913
Name:SAPOV, LIAT TATYANA (FNP)
Entity type:Individual
Prefix:
First Name:LIAT
Middle Name:TATYANA
Last Name:SAPOV
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 S. TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-8901
Mailing Address - Country:US
Mailing Address - Phone:941-300-9111
Mailing Address - Fax:
Practice Address - Street 1:1307 S. TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-8901
Practice Address - Country:US
Practice Address - Phone:941-300-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily