Healthcare Provider Details

I. General information

NPI: 1295652154
Provider Name (Legal Business Name): SHARKAIE MCCUTCHEON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8937 SW 9TH ST
BOCA RATON FL
33433-6217
US

IV. Provider business mailing address

8937 SW 9TH ST
BOCA RATON FL
33433-6217
US

V. Phone/Fax

Practice location:
  • Phone: 954-774-2179
  • Fax:
Mailing address:
  • Phone: 954-774-2179
  • Fax: 954-774-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SHARKAIE L MCCUTCHEON
Title or Position: OWNER
Credential:
Phone: 954-774-2179