Provider Demographics
NPI:1477077451
Name:ASTROLOGO, SHARON DENISE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:ASTROLOGO
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 1:421 S KEECH ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4623
Mailing Address - Country:US
Mailing Address - Phone:386-238-4980
Mailing Address - Fax:386-254-3937
Practice Address - Street 1:421 S. KEECH ST.
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32164
Practice Address - Country:US
Practice Address - Phone:386-238-4980
Practice Address - Fax:386-254-3937
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator