Individual
SHEILA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CST, CSFA
Contact information
Practice address
981 TARPON AVE, SEBASTIAN, FL 32958-5147
(321) 508-8756
Mailing address
PO BOX 780642, SEBASTIAN, FL 32978-0642
(321) 508-8756
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
138914
FL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138914
THE NATIONAL BOARD OF SURGICAL TECHNOLOGIST AND SURGICAL ASSISTING
FL
Enumeration date
03/23/2020
Last updated
05/08/2021
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