Provider Demographics
NPI:1558199109
Name:BERRINGER, SEAN (PA)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BERRINGER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 S POLK AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4800
Mailing Address - Country:US
Mailing Address - Phone:863-670-0257
Mailing Address - Fax:
Practice Address - Street 1:7375 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-3246
Practice Address - Country:US
Practice Address - Phone:863-325-8185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program