1518113620 NPI number — SARA ELIZABETH MCLEAR ARNP-C

Table of content: SARA ELIZABETH MCLEAR ARNP-C (NPI 1518113620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518113620 NPI number — SARA ELIZABETH MCLEAR ARNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLEAR
Provider First Name:
SARA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHALKLEY
Provider Other First Name:
SARA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518113620
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636116
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-6116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-289-9613
Provider Business Mailing Address Fax Number:
813-418-4112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 N ROCKY POINT DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-289-9613
Provider Business Practice Location Address Fax Number:
727-545-9988
Provider Enumeration Date:
08/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  ARNP9182223 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: ARNP918222 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)