Provider Demographics
NPI:1972031136
Name:GRIFFITHS, SANDRA FAY
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:FAY
Last Name:GRIFFITHS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13536 TURTLE MARSH LOOP APT 524
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6621
Mailing Address - Country:US
Mailing Address - Phone:407-247-7577
Mailing Address - Fax:
Practice Address - Street 1:1120 W DONEGAN AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2247
Practice Address - Country:US
Practice Address - Phone:407-201-7749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15729224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty