Provider Demographics
NPI:1295837995
Name:SHARMA, SHEKHAR VEERUBHOTLA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEKHAR
Middle Name:VEERUBHOTLA
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 STATE ROAD 7
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8095
Mailing Address - Country:US
Mailing Address - Phone:561-795-9087
Mailing Address - Fax:561-795-4036
Practice Address - Street 1:3347 STATE ROAD 7
Practice Address - Street 2:SUITE 200
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8095
Practice Address - Country:US
Practice Address - Phone:561-795-9087
Practice Address - Fax:561-795-4036
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47072207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049760600Medicaid
FLK1552Medicare PIN
FL03716ZMedicare ID - Type Unspecified
FL049760600Medicaid