MEDICARE: MS. SHARA AILEEN RABONE

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	222Q00000X	Developmental Therapist
2	235Z00000X	Speech-Language Pathologist	SA7536	FL

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

General Provider Information

NPI Number	:	1922506922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARA AILEEN RABONE

Provider Business Mailing Address
First Line	:	12639 NW 56TH DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3480
Country	:	US
Telephone Number	:	954-709-8376
Fax Number	:

Provider Business Practice Location Address
First Line	:	12639 NW 56TH DRIVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3307
Country	:	US
Telephone Number	:	954-709-8376
Fax Number	:	954-709-8376

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

Provider Enumeration Date	:	01/25/2018
Last Update Date	:	01/25/2018

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