Healthcare Provider Details

I. General information

NPI: 1023412368
Provider Name (Legal Business Name): RAVI SHARMA ARNP, FNP-C, PMHNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4185 US HIGHWAY 1
ROCKLEDGE FL
32955-4361
US

IV. Provider business mailing address

2352 OKALANI ST
PALM SHORES FL
32940-7300
US

V. Phone/Fax

Practice location:
  • Phone: 321-638-0027
  • Fax: 321-256-5200
Mailing address:
  • Phone: 815-508-0600
  • Fax: 943-206-3876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9378451
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9378451
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP95008949
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95008949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: