Provider Demographics
NPI:1053097030
Name:FITZPATRICK, SHEALYN PATRICIA (APRN)
Entity type:Individual
Prefix:
First Name:SHEALYN
Middle Name:PATRICIA
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N ALAFAYA TRL STE 900
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4737
Mailing Address - Country:US
Mailing Address - Phone:407-380-8705
Mailing Address - Fax:407-643-2804
Practice Address - Street 1:1900 N ALAFAYA TRL STE 900
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4737
Practice Address - Country:US
Practice Address - Phone:407-380-8705
Practice Address - Fax:407-643-2804
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034385363LF0000X
FLAPRN11034385363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily