Healthcare Provider Details

I. General information

NPI: 1366990111
Provider Name (Legal Business Name): MEGAN SEARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13465 FISHHAWK BLVD
LITHIA FL
33547-3833
US

IV. Provider business mailing address

13465 FISHHAWK BLVD
LITHIA FL
33547-3833
US

V. Phone/Fax

Practice location:
  • Phone: 813-324-8009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL4862
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: