Provider Demographics
NPI:1912307414
Name:DAHBOUR, SARA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MICHELLE
Last Name:DAHBOUR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:MICHELLE
Other - Last Name:PYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:7807 BAYMEADOWS RD E STE 207
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9666
Mailing Address - Country:US
Mailing Address - Phone:904-446-9991
Mailing Address - Fax:904-446-9992
Practice Address - Street 1:7807 BAYMEADOWS RD E STE 207
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9666
Practice Address - Country:US
Practice Address - Phone:904-446-9991
Practice Address - Fax:904-446-9992
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295694363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013091700Medicaid