MEDICARE: SHARAD VYAS 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	208000000X	Pediatrics Physician	ME33726	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	:	1750367686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARAD VYAS MD

Provider Business Mailing Address
First Line	:	2186 HARRIS AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4044
Country	:	US
Telephone Number	:	321-725-8111
Fax Number	:	321-984-0552

Provider Business Practice Location Address
First Line	:	2186 HARRIS AVE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4044
Country	:	US
Telephone Number	:	321-725-8111
Fax Number	:	321-984-0552

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	08/17/2011

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Directions to “ SHARAD VYAS MD” Practice Location

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