Provider Demographics
NPI:1912755976
Name:HUENEKE, SARA ROSE (DNAP, APRN, CRNA)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ROSE
Last Name:HUENEKE
Suffix:
Gender:F
Credentials:DNAP, APRN, CRNA
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ROSE
Other - Last Name:FABBRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1110 HUNTER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-2849
Mailing Address - Country:US
Mailing Address - Phone:321-961-3769
Mailing Address - Fax:
Practice Address - Street 1:851 TRAFALGAR CT STE 200E
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7420
Practice Address - Country:US
Practice Address - Phone:888-339-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL149057367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty