Provider Demographics
NPI:1730270414
Name:SHUFORD, MARSHA D (OTR CHT)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:D
Last Name:SHUFORD
Suffix:
Gender:F
Credentials:OTR CHT
Other - Prefix:
Other - First Name:MARSHEI
Other - Middle Name:D
Other - Last Name:DELUGAEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE E120
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5353
Mailing Address - Country:US
Mailing Address - Phone:941-955-2020
Mailing Address - Fax:941-955-2120
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE E120
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5353
Practice Address - Country:US
Practice Address - Phone:941-955-2020
Practice Address - Fax:941-955-2120
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT396225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2488BMedicare ID - Type Unspecified