Provider Demographics
NPI:1538310669
Name:GERTHOFFER, SHARON (LMT)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:
Last Name:GERTHOFFER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PINE DR
Mailing Address - Street 2:APT 104
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-7266
Mailing Address - Country:US
Mailing Address - Phone:954-816-7527
Mailing Address - Fax:
Practice Address - Street 1:1140 SE3RD AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316
Practice Address - Country:US
Practice Address - Phone:954-816-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA36878174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist