Provider Demographics
NPI:1992430318
Name:ACADO, SARAH JELLE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JELLE
Last Name:ACADO
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 1:438 NE 210TH CIRCLE TER APT 106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1854
Mailing Address - Country:US
Mailing Address - Phone:786-663-6147
Mailing Address - Fax:
Practice Address - Street 1:438 NE 210TH CIRCLE TER APT 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1854
Practice Address - Country:US
Practice Address - Phone:786-663-6147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSTUDENT363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool