Provider Demographics
NPI:1033303623
Name:WATT, SHARON MAY (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MAY
Last Name:WATT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 NW 72ND CT
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2436
Mailing Address - Country:US
Mailing Address - Phone:954-757-9215
Mailing Address - Fax:
Practice Address - Street 1:600 N HIATUS RD
Practice Address - Street 2:SUITE # 203
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5207
Practice Address - Country:US
Practice Address - Phone:954-392-7157
Practice Address - Fax:954-443-4941
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1906562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ205ZMedicare PIN