Healthcare Provider Details

I. General information

NPI: 1356166318
Provider Name (Legal Business Name): JESSICA LATOYA SHERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LATOYA LITTLES

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5768 S SEMORAN BLVD
ORLANDO FL
32822-4818
US

IV. Provider business mailing address

1096 VISTA HAVEN CIR APT 302
ORLANDO FL
32825-3555
US

V. Phone/Fax

Practice location:
  • Phone: 407-404-2321
  • Fax:
Mailing address:
  • Phone: 321-243-0122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: