Provider Demographics
NPI:1932128493
Name:SHERRARD, PETER A D (EDD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A D
Last Name:SHERRARD
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:ANDREW DOUGLAS
Other - Last Name:SHERRARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9518 SW 53RD RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4344
Mailing Address - Country:US
Mailing Address - Phone:352-336-8093
Mailing Address - Fax:352-336-8093
Practice Address - Street 1:4850 SW 91ST TER
Practice Address - Street 2:SUITE P-102
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-6038
Practice Address - Country:US
Practice Address - Phone:352-373-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001989101YM0800X
FLMT0001155106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist