Provider Demographics
NPI:1083846513
Name:SHARKEY, CARRIE LENEIGH MINICK (MSPT, COMT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LENEIGH MINICK
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:MSPT, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-3909
Mailing Address - Country:US
Mailing Address - Phone:941-475-3516
Mailing Address - Fax:941-475-3403
Practice Address - Street 1:925 S RIVER RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3909
Practice Address - Country:US
Practice Address - Phone:941-475-3516
Practice Address - Fax:941-475-3403
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24762225100000X
OHPT0082182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist