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General NPI Number Information
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NPI Number | 1104263839
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Entity Type | Individual
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Provider Name | AYUSHMAN SHARMA MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 4250 HOSPITAL DR
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City | MARIANNA
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State | FL
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Zip | 32446-1917
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Country | US
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Telephone | 850-526-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 10602 CARDERA DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-4704
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Country | US
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Telephone | 515-509-1585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | ME140005
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 22123
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME140005
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License Number State | FL
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