Provider Demographics
NPI:1346892593
Name:PAZ, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 NW 9TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-4036
Mailing Address - Country:US
Mailing Address - Phone:239-850-9168
Mailing Address - Fax:
Practice Address - Street 1:12811 KENWOOD LN STE 202
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5646
Practice Address - Country:US
Practice Address - Phone:239-537-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health