MEDICARE: MS. CARMITHA M SHERMAN PT

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	225100000X	Physical Therapist	PT00009303	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	196326	OTHER	WA	DEPT OF L&I
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	7575693	OTHER	WA	AETNA
4	5543MA	OTHER	WA	REGENCE BS
5	8905598	OTHER	WA	CRIME VICTIMS

General Provider Information

NPI Number	:	1801888540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMITHA M SHERMAN PT

Provider Business Mailing Address
First Line	:	2410 W BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4717
Country	:	US
Telephone Number	:	813-654-0686
Fax Number	:

Provider Business Practice Location Address
First Line	:	2410 W BRANDON BLVD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-4717
Country	:	US
Telephone Number	:	813-654-0686
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	01/11/2022

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