MEDICARE: DR. MARC IRWIN SHARFMAN M.D.

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	2084N0400X	Neurology Physician	ME0059331	FL

General Provider Information

NPI Number	:	1750376364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC IRWIN SHARFMAN M.D.

Provider Business Mailing Address
First Line	:	2137 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4983
Country	:	US
Telephone Number	:	407-644-3737
Fax Number	:	407-644-3009

Provider Business Practice Location Address
First Line	:	2137 W STATE ROAD 434
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32779-4983
Country	:	US
Telephone Number	:	407-644-3737
Fax Number	:	407-644-3009

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	09/07/2011

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