MEDICARE: MRS. SHARMA S ELDRIDGE RN, CMC, NCG

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	163W00000X	Registered Nurse	RN1372342	FL
2	163WC0400X	Case Management Registered Nurse	RN1372342	FL
3	171M00000X	Case Manager/Care Coordinator	RN1372342	FL
4	163WA2000X	Administrator Registered Nurse	RN1372342	FL
5	163WC1600X	Continuing Education/Staff Development Registered Nurse	RN1372342	FL
6	163WG0600X	Gerontology Registered Nurse	RN1372342	FL
7	163WH0200X	Home Health Registered Nurse	RN1372342	FL
8	163WI0500X	Infusion Therapy Registered Nurse	RN1372342	FL
9	101Y00000X	Counselor	RN1372342	FL
10	163WD0400X	Diabetes Educator Registered Nurse	RN1372342	FL
11	163WX0002X	High-Risk Obstetric Registered Nurse	RN1372342	FL
12	174400000X	Specialist	RN1372342	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CMC	OTHER		NATIONALLY-CERTIFIED GERIATRIC CARE MANAGER
2	NCG	OTHER	FL	NATIONALLY-CERTIFIED GUARDIAN

General Provider Information

NPI Number	:	1497000624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARMA S ELDRIDGE RN, CMC, NCG

Provider Business Mailing Address
First Line	:	7280 STIRLING RD
Second Line	:	#101
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-1676
Country	:	US
Telephone Number	:	954-401-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	7280 STIRLING RD
Second Line	:	#101
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-1676
Country	:	US
Telephone Number	:	954-401-5214
Fax Number	:

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

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	03/28/2013

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