Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shannon Domfort

Individual provider Pediatric Occupational Therapist · NPI 1376912063

Shannon Domfort is a Pediatric Occupational Therapist in Saint Petersburg, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2015
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4200 4th St N Ste B
Saint Petersburg, FL 33703-4735
Phone: (727) 592-5417
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence OT20621 (FL)

Record details

NPI number1376912063
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 23, 2015
Last updated in NPPESJune 22, 2026
Certification dateJune 22, 2026
Mailing address4200 4th St N Ste B, Saint Petersburg, FL 33703-4735

Other providers in Saint Petersburg