MEDICARE: SEAN DOUGLAS FERRER ERGINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11044100	FL

General Provider Information

NPI Number	:	1043156730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN DOUGLAS FERRER ERGINA

Provider Business Mailing Address
First Line	:	200 WHISTLING DUCK TRL
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-9364
Country	:	US
Telephone Number	:	561-601-4096
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 LIVE OAK BLVD STE B&C
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8408
Country	:	US
Telephone Number	:	407-593-2388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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