Healthcare Provider Details

I. General information

NPI: 1457165409
Provider Name (Legal Business Name): KAYLA SHARP PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 VETERANS PARK DR STE 101
NAPLES FL
34109-0447
US

IV. Provider business mailing address

1865 VETERANS PARK DR STE 101N
NAPLES FL
34109-0447
US

V. Phone/Fax

Practice location:
  • Phone: 239-254-7778
  • Fax:
Mailing address:
  • Phone: 239-254-7778
  • Fax: 855-959-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: