Provider Demographics
NPI:1003442807
Name:SHERIDAN, LAUREN CHERYL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CHERYL
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:CHERYL
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5001 BRIDGE ST APT 4610
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3273
Mailing Address - Country:US
Mailing Address - Phone:440-840-8060
Mailing Address - Fax:
Practice Address - Street 1:5035 E BUSCH BLVD STE 7
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-5310
Practice Address - Country:US
Practice Address - Phone:813-631-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-13
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20736225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist