Healthcare Provider Details

I. General information

NPI: 1891150231
Provider Name (Legal Business Name): SHARON DILLON MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2015
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 N WICKHAM RD STE 6
MELBOURNE FL
32935-2322
US

IV. Provider business mailing address

3150 N WICKHAM RD STE 6
MELBOURNE FL
32935-2322
US

V. Phone/Fax

Practice location:
  • Phone: 321-242-3227
  • Fax: 321-242-4934
Mailing address:
  • Phone: 321-242-3227
  • Fax: 321-242-4934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME63734
License Number StateFL

VIII. Authorized Official

Name: DR. SHARON A. DILLON
Title or Position: PRESIDENT
Credential: MD
Phone: 321-242-3227