Provider Demographics
NPI:1538283288
Name:TREASURE COAST EAR NOSE & THROAT PA
Entity Type:Organization
Organization Name:TREASURE COAST EAR NOSE & THROAT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-220-8459
Mailing Address - Street 1:2221 SE OCEAN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3341
Mailing Address - Country:US
Mailing Address - Phone:772-220-8459
Mailing Address - Fax:772-220-4733
Practice Address - Street 1:2221 SE OCEAN BLVD STE 300
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3341
Practice Address - Country:US
Practice Address - Phone:772-220-8459
Practice Address - Fax:772-220-4733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCB4896OtherRAILROAD MEDICARE PIN
FL33965Medicare PIN