Provider Demographics
NPI:1669515243
Name:DARLIN, SALLY STICKEL (PT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:STICKEL
Last Name:DARLIN
Suffix:
Gender:F
Credentials:PT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 STONER RD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3121
Mailing Address - Country:US
Mailing Address - Phone:407-468-3104
Mailing Address - Fax:
Practice Address - Street 1:1155 S ORLANDO AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4852
Practice Address - Country:US
Practice Address - Phone:407-468-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 6501225100000X
FLAT 16282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer