Provider Demographics
NPI:1376774059
Name:SHARMA, HIMANSHU (MD)
Entity Type:Individual
Prefix:DR
First Name:HIMANSHU
Middle Name:
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:PO BOX 677879
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32867-7879
Mailing Address - Country:US
Mailing Address - Phone:407-440-3004
Mailing Address - Fax:407-429-3899
Practice Address - Street 1:7727 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8224
Practice Address - Country:US
Practice Address - Phone:407-440-3004
Practice Address - Fax:407-429-3899
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT194577207R00000X
FLME121252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013799400Medicaid
FL013799400Medicaid