Provider Demographics
NPI:1073073524
Name:YADVEN, SHARON RODGERS (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:RODGERS
Last Name:YADVEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 LANDINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-9675
Mailing Address - Country:US
Mailing Address - Phone:941-518-5558
Mailing Address - Fax:
Practice Address - Street 1:2407 LANDINGS CIR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-9675
Practice Address - Country:US
Practice Address - Phone:941-518-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist