Provider Demographics
NPI:1427194950
Name:SHEEHY, MARILYN SYLVIA (L)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:SYLVIA
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:L
Other - Prefix:MRS
Other - First Name:MARILYN
Other - Middle Name:SYLVIA
Other - Last Name:AGAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9508 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3416
Mailing Address - Country:US
Mailing Address - Phone:954-689-0730
Mailing Address - Fax:888-725-9013
Practice Address - Street 1:9508 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3416
Practice Address - Country:US
Practice Address - Phone:954-689-0730
Practice Address - Fax:888-725-9013
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 8715225XP0200X
FLOT8715225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist