Healthcare Provider Details

I. General information

NPI: 1386627768
Provider Name (Legal Business Name): NEEKAYTAN SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18669 TAMIAMI TRL STE B
NORTH PORT FL
34287-7388
US

IV. Provider business mailing address

18669 TAMIAMI TRL STE B
NORTH PORT FL
34287-7388
US

V. Phone/Fax

Practice location:
  • Phone: 941-423-5040
  • Fax: 941-423-5042
Mailing address:
  • Phone: 941-423-5040
  • Fax: 941-423-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberFLME00050176
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: