Healthcare Provider Details

I. General information

NPI: 1720949845
Provider Name (Legal Business Name): SARAH JANE SHEAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 MAX LEGGETT PKWY
JACKSONVILLE FL
32218-7273
US

IV. Provider business mailing address

4741 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 904-383-1000
  • Fax:
Mailing address:
  • Phone: 717-972-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number26421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: