Provider Demographics
NPI:1841774171
Name:LEFORT, SEAN ROBERT (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:ROBERT
Last Name:LEFORT
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7469
Mailing Address - Fax:
Practice Address - Street 1:3050 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1010
Practice Address - Country:US
Practice Address - Phone:727-321-4846
Practice Address - Fax:727-321-3811
Is Sole Proprietor?:No
Enumeration Date:2018-09-22
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9344848163WE0003X
FLAPRN11000320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency