MEDICARE: WILLIAM SHERIDAN PTA

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	225200000X	Physical Therapy Assistant	PTA18684	FL

General Provider Information

NPI Number	:	1982733853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SHERIDAN PTA

Provider Business Mailing Address
First Line	:	2976 HUNTERS LN
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32766-5072
Country	:	US
Telephone Number	:	407-365-1451
Fax Number	:

Provider Business Practice Location Address
First Line	:	7350 SANDLAKE COMMONS BLVD STE 3315
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-8031
Country	:	US
Telephone Number	:	407-354-3700
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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Directions to “ WILLIAM SHERIDAN PTA” Practice Location

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