Provider Demographics
NPI:1033486055
Name:MAXWELL-CROOKS, SHERON
Entity Type:Individual
Prefix:
First Name:SHERON
Middle Name:
Last Name:MAXWELL-CROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 NW 60TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-2942
Mailing Address - Country:US
Mailing Address - Phone:954-394-1336
Mailing Address - Fax:954-893-9455
Practice Address - Street 1:2251 NW 60TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-2942
Practice Address - Country:US
Practice Address - Phone:954-394-1336
Practice Address - Fax:954-893-9455
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA111185374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide