Provider Demographics
NPI:1144774555
Name:SHEFFIELD, ANGELA KATHLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHLEEN
Last Name:SHEFFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11404 PALDAO RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3924
Mailing Address - Country:US
Mailing Address - Phone:352-584-6414
Mailing Address - Fax:
Practice Address - Street 1:11404 PALDAO RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3924
Practice Address - Country:US
Practice Address - Phone:352-584-6414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109232363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018502600Medicaid
FLKV2CWOtherBLUE CROSS
FLKV2CWOtherBLUE CROSS