Healthcare Provider Details

I. General information

NPI: 1760588255
Provider Name (Legal Business Name): SHARON L. FLATOW L.M.H.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 MAITLAND AVE STE 108
ALTAMONTE SPRINGS FL
32701-4914
US

IV. Provider business mailing address

251 MAITLAND AVE STE 108
ALTAMONTE SPRINGS FL
32701-4914
US

V. Phone/Fax

Practice location:
  • Phone: 407-260-5666
  • Fax: 407-260-9790
Mailing address:
  • Phone: 407-260-5666
  • Fax: 407-260-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH1733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: