MEDICARE: DR. JERROLD SHARKEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME-16484	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235194804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERROLD SHARKEY MD

Provider Business Mailing Address
First Line	:	3100 MEADOW VIEW LN
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2034
Country	:	US
Telephone Number	:	727-786-4531
Fax Number	:	206-338-3541

Provider Business Practice Location Address
First Line	:	3100 MEADOW VIEW LN
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-2034
Country	:	US
Telephone Number	:	727-786-4531
Fax Number	:	206-338-3541

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	06/27/2016

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