Healthcare Provider Details

I. General information

NPI: 1205081387
Provider Name (Legal Business Name): SHARON L CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 CHAMPIONS CIR APT 304
CHAMPIONS GATE FL
33896-9623
US

IV. Provider business mailing address

8121 CHAMPIONS CIR APT 304
CHAMPIONS GATE FL
33896-9623
US

V. Phone/Fax

Practice location:
  • Phone: 302-507-3431
  • Fax:
Mailing address:
  • Phone: 302-507-3431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA23309
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-0002630
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: