MEDICARE: SHARON DIANNE COPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		FL
2	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265592216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON DIANNE COPE

Provider Business Mailing Address
First Line	:	7186 COON RD
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33917-3207
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7186 COON RD
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33917-3207
Country	:	US
Telephone Number	:	863-233-9023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	02/24/2011

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