Provider Demographics
NPI:1801236518
Name:OBRADOVICH, SARAH CATHERINE LYNCH (ARNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE LYNCH
Last Name:OBRADOVICH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CATHERINE
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 44004
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4004
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:2140 SMITH ST
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5554
Practice Address - Country:US
Practice Address - Phone:904-269-2140
Practice Address - Fax:904-376-4107
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9306381363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009215600Medicaid