Provider Demographics
NPI:1326339284
Name:DELGADO OCASIO, SHARON MARIE (OT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:DELGADO OCASIO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3907 VISTA GROVE LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-2159
Mailing Address - Country:US
Mailing Address - Phone:507-398-9610
Mailing Address - Fax:
Practice Address - Street 1:5881 NW 151ST ST
Practice Address - Street 2:SUITE 123
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2450
Practice Address - Country:US
Practice Address - Phone:954-753-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14081225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008195400Medicaid