Provider Demographics
NPI:1639685944
Name:O'CONNELL, SHERYL LEE (MBA, MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LEE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MBA, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:2840 SE 3RD CT STE 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0480
Practice Address - Country:US
Practice Address - Phone:352-622-1777
Practice Address - Fax:352-622-1929
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9283837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH1ARJOtherBCBS
FLOM166OtherMEDICARE