Provider Demographics
NPI:1184924326
Name:SHERWOOD, RANDALL TODD (PSYD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:TODD
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 NW 36TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-8813
Mailing Address - Country:US
Mailing Address - Phone:352-281-4044
Mailing Address - Fax:352-204-1882
Practice Address - Street 1:6221 NW 36TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-8813
Practice Address - Country:US
Practice Address - Phone:352-281-4044
Practice Address - Fax:352-204-1882
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8833103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical