MEDICARE: SEAN STEVENS-FERGUSON PA-C

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	363A00000X	Physician Assistant	PA9121380	FL

General Provider Information

NPI Number	:	1467307991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN STEVENS-FERGUSON PA-C

Provider Business Mailing Address
First Line	:	10025 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-4329
Country	:	US
Telephone Number	:	407-382-4218
Fax Number	:	407-380-3228

Provider Business Practice Location Address
First Line	:	10025 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-4329
Country	:	US
Telephone Number	:	407-382-4218
Fax Number	:	407-380-3228

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	04/23/2026

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Directions to “ SEAN STEVENS-FERGUSON PA-C” Practice Location

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