Healthcare Provider Details

I. General information

NPI: 1962783191
Provider Name (Legal Business Name): SHARON SOKOLOW ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9033 GLADES RD.
BOCA RATON FL
33434
US

IV. Provider business mailing address

9033 GLADES RD.
BOCA RATON FL
33434
US

V. Phone/Fax

Practice location:
  • Phone: 561-361-0500
  • Fax: 561-479-0384
Mailing address:
  • Phone: 561-361-0500
  • Fax: 561-479-0384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: