Healthcare Provider Details

I. General information

NPI: 1477872885
Provider Name (Legal Business Name): RAGHAV SHARMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 N ORLANDO AVE STE 205
WINTER PARK FL
32789-2213
US

IV. Provider business mailing address

1035 N ORLANDO AVE STE 205
WINTER PARK FL
32789-2213
US

V. Phone/Fax

Practice location:
  • Phone: 321-274-8701
  • Fax: 321-274-8702
Mailing address:
  • Phone: 321-274-8701
  • Fax: 321-274-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberC1407
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMT197908
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number272390
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME139953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: