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NPI Code Detail

MEDICARE: SHARON Z WILCOX LMHE

MEDICARE: SHARON Z WILCOX LMHE
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
1101Y00000XCounselorMH7045FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
279213000OTHERFLMAGELLAN
3Z0785OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1437146859
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON Z WILCOX LMHE
Provider Business Mailing Address
First Line : PO BOX 1559
Second Line :
City : BARTOW
State : FL
Zip : 33831-1559
Country : US
Telephone Number : 863-519-0575
Fax Number : 863-534-7028
Provider Business Practice Location Address
First Line : 1835 GILMORE AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3017
Country : US
Telephone Number : 863-248-3300
Fax Number : 863-534-7028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 04/30/2008

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