Provider Demographics
NPI:1619067444
Name:TINDELL, SHERYL B (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:B
Last Name:TINDELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:B
Other - Last Name:MERKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-7770
Mailing Address - Country:US
Mailing Address - Phone:813-396-9638
Mailing Address - Fax:
Practice Address - Street 1:13220 USF LAUREL DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4742
Practice Address - Country:US
Practice Address - Phone:813-396-9638
Practice Address - Fax:813-974-2652
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9291254163WD0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002197500Medicaid
FLY04L3OtherBLUE CROSS BLUE SHIELD
FLY04L3OtherBLUE CROSS BLUE SHIELD