Provider Demographics
NPI:1497000624
Name:ELDRIDGE, SHARMA S (RN, CMC, NCG)
Entity Type:Individual
Prefix:MRS
First Name:SHARMA
Middle Name:S
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:RN, CMC, NCG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7280 STIRLING RD
Mailing Address - Street 2:#101
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1676
Mailing Address - Country:US
Mailing Address - Phone:954-401-5214
Mailing Address - Fax:
Practice Address - Street 1:7280 STIRLING RD
Practice Address - Street 2:#101
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1676
Practice Address - Country:US
Practice Address - Phone:954-401-5214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1372342163W00000X, 163WC0400X, 171M00000X, 163WA2000X, 163WC1600X, 163WG0600X, 163WH0200X, 163WI0500X, 101Y00000X, 163WD0400X, 163WX0002X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CMCOtherNATIONALLY-CERTIFIED GERIATRIC CARE MANAGER
FLNCGOtherNATIONALLY-CERTIFIED GUARDIAN