Provider Demographics
NPI:1538317722
Name:APEX ANTI-AGING INC.
Entity Type:Organization
Organization Name:APEX ANTI-AGING INC.
Other - Org Name:APEX HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP
Authorized Official - Phone:727-596-4878
Mailing Address - Street 1:9011 PARK BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4123
Mailing Address - Country:US
Mailing Address - Phone:727-596-4878
Mailing Address - Fax:727-213-6701
Practice Address - Street 1:9011 PARK BLVD STE 209
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4123
Practice Address - Country:US
Practice Address - Phone:727-596-4878
Practice Address - Fax:727-213-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6450170001Medicare NSC