MEDICARE: SHARON KHAN LEPAK DO

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	207Q00000X	Family Medicine Physician	OS5118	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	:	1700875127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON KHAN LEPAK DO

Provider Business Mailing Address
First Line	:	PO BOX 417
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34995-0417
Country	:	US
Telephone Number	:	772-223-5665
Fax Number	:	772-223-5646

Provider Business Practice Location Address
First Line	:	3801 S KANNER HWY STE 300
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-4801
Country	:	US
Telephone Number	:	772-781-2791
Fax Number	:	772-223-2819

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	10/12/2020

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Directions to “ SHARON KHAN LEPAK DO” Practice Location

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