MEDICARE: DR. VIJAY M SHARMA MD

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	207YS0123X	Facial Plastic Surgery Physician	025413	LA
2	207YS0123X	Facial Plastic Surgery Physician	ME96274	FL

General Provider Information

NPI Number	:	1356595268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIJAY M SHARMA MD

Provider Business Mailing Address
First Line	:	601 UNIVERSITY BLVD STE 201
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2788
Country	:	US
Telephone Number	:	561-277-0699
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 UNIVERSITY BLVD STE 201
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-2788
Country	:	US
Telephone Number	:	561-277-0699
Fax Number	:

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

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	05/07/2018

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