MEDICARE: AMANDA LYNN SHERFIELD MSPT

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	225100000X	Physical Therapist	PT 23635	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578752838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LYNN SHERFIELD MSPT

Provider Business Mailing Address
First Line	:	5401 ROCKWOOD AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-6917
Country	:	US
Telephone Number	:	407-256-1557
Fax Number	:

Provider Business Practice Location Address
First Line	:	8291 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-7890
Country	:	US
Telephone Number	:	407-852-3300
Fax Number	:	407-852-3334

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

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	07/23/2014

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