Healthcare Provider Details

I. General information

NPI: 1801987656
Provider Name (Legal Business Name): BRUNO SHARP D.D.S., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 S BAYSHORE DR SUITE 760
COCONUT GROVE FL
33133-5417
US

IV. Provider business mailing address

2601 S BAYSHORE DR SUITE 760
COCONUT GROVE FL
33133-5417
US

V. Phone/Fax

Practice location:
  • Phone: 305-857-0990
  • Fax: 305-857-9180
Mailing address:
  • Phone: 305-857-0990
  • Fax: 305-857-9180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN13965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: