Organization · Type 2 NPI
Sheridan Childrens Healthcare Services Inc
Pediatric Nurse Practitioner · Fort Walton Beach, FL
NPI number
1164628624
Active
Practice location
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Mailing address
1613 NW 136th Ave, Building C, Suite #200
Sunrise, FL 33323-2853
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | None listed |
| Physician Assistant | 363A00000X | None listed |
| Neonatal Nurse Practitioner | 363LN0000X | None listed |
| Pediatric Nurse Practitioner Primary | 363LP0200X | None listed |
| Perinatal Nurse Practitioner | 363LP1700X | None listed |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1164628624
Sheridan Childrens Healthcare Services Inc's National Provider Identifier is 1164628624, issued on Jun 22, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Fort Walton Beach, FL. The record was last updated on Sep 11, 2025.