Healthcare Provider Details
I. General information
NPI: 1760570626
Provider Name (Legal Business Name): SHARLA GAYLE PATTERSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3530 KRAFT RD STE 202
NAPLES FL
34105-5020
US
IV. Provider business mailing address
11181 HEALTH PARK BLVD STE 1115
NAPLES FL
34110-5742
US
V. Phone/Fax
- Phone: 239-758-7465
- Fax:
- Phone: 239-758-7465
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 062152 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 27211 |
| License Number State | AL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | ME115033 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 21116 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: