Individual provider Active NPI

Sasha R. Petit Frere

  • Student in an Organized Health Care Education/Training Program
  • Fort Myers, FL
National Provider Identifier
1376423822
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
9591210 Issued in FL
Practice address
10501 Fgcu Blvd S
Fort Myers, FL 33965-6502
Phone
(239) 590-1000
NPI assigned
Sep 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9591210 FL
Student in an Organized Health Care Education/Training Program 390200000X 9591210 FL Primary

Addresses

Primary practice location

10501 Fgcu Blvd S
Fort Myers, FL 33965-6502

Mailing address

334 Ranch Ave
Lehigh Acres, FL 33974-0483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9591210FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1376423822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 RANCH AVE",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339740483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 FGCU BLVD S",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339656502",
            "telephone_number": "239-590-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT FRERE",
        "first_name": "SASHA",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9591210",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "9591210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.