Provider Demographics
NPI:1841542289
Name:ELNEMR, SARA (DR)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:ELNEMR
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 PINEAPPLE PRESERVE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-9726
Mailing Address - Country:US
Mailing Address - Phone:239-405-2266
Mailing Address - Fax:
Practice Address - Street 1:15601 SAN CARLOS BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2570
Practice Address - Country:US
Practice Address - Phone:239-489-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49855183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist