=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619233095
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASHOK P SHARMA MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2012
-----------------------------------------------------
Last Update Date | 04/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16244 S MILITARY TRL SUITE 250
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-499-4739
-----------------------------------------------------
Fax | 561-499-7371
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16244 SOUTH MILITARY TRAIL SUITE 250
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-499-4739
-----------------------------------------------------
Fax | 561-499-7371
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASHOK P SHARMA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 561-499-4739
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------