Basic Information
| Provider Information | |||||||||
| NPI: | 1083968226 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | BRANTLEY | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 E PRINCETON ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073035781 | ||||||||
| FaxNumber: | 4073035794 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 E PRINCETON ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073035781 | ||||||||
| FaxNumber: | 4073035794 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2012 | ||||||||
| LastUpdateDate: | 10/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0200X | 9277140 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Pediatrics | 363LP0200X | APRN9277140 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.