Provider Demographics
NPI:1255881454
Name:MADDEN, SHEILA (PT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:9020 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-5524
Mailing Address - Country:US
Mailing Address - Phone:850-475-0555
Mailing Address - Fax:
Practice Address - Street 1:9020 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5524
Practice Address - Country:US
Practice Address - Phone:850-475-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist