Healthcare Provider Details

I. General information

NPI: 1316859739
Provider Name (Legal Business Name): SHARON HAZEL CARBAJAL PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 SEMINOLE BLVD
LARGO FL
33770-3627
US

IV. Provider business mailing address

31357 AMBERVIEW BND
WESLEY CHAPEL FL
33545-4519
US

V. Phone/Fax

Practice location:
  • Phone: 727-238-3241
  • Fax:
Mailing address:
  • Phone: 727-238-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11050905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: