Provider Demographics
NPI:1861778078
Name:SORIANO, SHEILAH SERMANA (PT)
Entity type:Individual
Prefix:
First Name:SHEILAH
Middle Name:SERMANA
Last Name:SORIANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 SHUG JORDAN PKWY
Mailing Address - Street 2:APARTMENT 216
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-4324
Mailing Address - Country:US
Mailing Address - Phone:321-946-0912
Mailing Address - Fax:
Practice Address - Street 1:702 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LANETT
Practice Address - State:AL
Practice Address - Zip Code:36863-2834
Practice Address - Country:US
Practice Address - Phone:334-644-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6280225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist