Individual
MARIA SOFIA SHEAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
601 5TH ST S, FLOOR 3, ST PETERSBURG, FL 33701-4804
(727) 767-4150
Mailing address
2108 N OLA AVE UNIT 316, TAMPA, FL 33602-2022
(239) 410-3917
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11025317
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118059800
—
FL
01
—
5BX0O
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/21/2023
Last updated
09/03/2024
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