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General NPI Number Information
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NPI Number | 1679281992
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Entity Type | Individual
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Provider Name | JAMIE SHARP
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 910 S WINTERHAWK DR UNIT 107
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-3870
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Country | US
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Telephone | 904-217-3914
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Fax |
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Provider Business Mailing Address
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Address Line | 289 N CHURCHILL DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-4169
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Country | US
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Telephone | 302-299-9340
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 23487
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License Number State | FL
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