Provider Demographics
NPI:1033502372
Name:SHARELL, ILONKA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ILONKA
Middle Name:
Last Name:SHARELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7808 32ND ST E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-4112
Mailing Address - Country:US
Mailing Address - Phone:941-724-0420
Mailing Address - Fax:
Practice Address - Street 1:7808 32ND ST E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-4112
Practice Address - Country:US
Practice Address - Phone:941-724-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0011683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist