Healthcare Provider Details

I. General information

NPI: 1043156730
Provider Name (Legal Business Name): SEAN DOUGLAS FERRER ERGINA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 LIVE OAK BLVD STE B&C
SAINT CLOUD FL
34771-8408
US

IV. Provider business mailing address

200 WHISTLING DUCK TRL
SAINT CLOUD FL
34771-9364
US

V. Phone/Fax

Practice location:
  • Phone: 407-593-2388
  • Fax:
Mailing address:
  • Phone: 561-601-4096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11044100
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: