Provider Demographics
NPI:1316838758
Name:WEATHERSPOON, SYLVIA (HHA)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:WEATHERSPOON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-5450
Mailing Address - Country:US
Mailing Address - Phone:850-712-0290
Mailing Address - Fax:
Practice Address - Street 1:1020 TORTUGA DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-3508
Practice Address - Country:US
Practice Address - Phone:850-712-0290
Practice Address - Fax:850-848-6524
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide