Provider Demographics
NPI:1083678981
Name:LAMKIN, SHARON D (PA-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:LAMKIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N 35TH AVE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5424
Mailing Address - Country:US
Mailing Address - Phone:954-963-7100
Mailing Address - Fax:954-981-0446
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-963-7100
Practice Address - Fax:954-981-0446
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102859363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ58779Medicare UPIN
FLU6573ZMedicare ID - Type Unspecified