Provider Demographics
NPI:1801888540
Name:SHERMAN, CARMITHA M (PT)
Entity type:Individual
Prefix:MS
First Name:CARMITHA
Middle Name:M
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CARMITHA
Other - Middle Name:N
Other - Last Name:MACATANGAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2410 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4717
Mailing Address - Country:US
Mailing Address - Phone:813-654-0686
Mailing Address - Fax:
Practice Address - Street 1:2410 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4717
Practice Address - Country:US
Practice Address - Phone:813-654-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA196326OtherDEPT OF L&I
WA8426223Medicaid
WA7575693OtherAETNA
WA5543MAOtherREGENCE BS
WA8905598OtherCRIME VICTIMS
WA8905598OtherCRIME VICTIMS
WA8853347Medicare ID - Type UnspecifiedPIERCE COUNTY