Provider Demographics
NPI:1740612886
Name:MCDOUGALL, SHARON SANDUSKI (MA OTR/L)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:SANDUSKI
Last Name:MCDOUGALL
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LINDA
Other - Last Name:SANDUSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3212 HILLSDALE LN
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7562
Mailing Address - Country:US
Mailing Address - Phone:407-906-9003
Mailing Address - Fax:
Practice Address - Street 1:5741 PARKVIEW POINT DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-7963
Practice Address - Country:US
Practice Address - Phone:818-268-2614
Practice Address - Fax:805-496-9301
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8002225X00000X
FLOT16685225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist