Provider Demographics
NPI:1851270615
Name:CAPURRO MUSA, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CAPURRO MUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 HARMONY DR S
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-3822
Mailing Address - Country:US
Mailing Address - Phone:646-239-5529
Mailing Address - Fax:
Practice Address - Street 1:12724 GRAN BAY PARKWAY WEST,
Practice Address - Street 2:SUITE 410
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-9486
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24392225106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician