Provider Demographics
NPI:1568549178
Name:SHARMA, RAKESH (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4881 NW 8TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-224-2204
Mailing Address - Fax:352-224-2451
Practice Address - Street 1:4343 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2817
Practice Address - Country:US
Practice Address - Phone:352-224-2204
Practice Address - Fax:352-375-6888
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074089207R00000X
FLME 105202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2136512Medicaid
OHSH0887373Medicare PIN
OH2136512Medicaid
OH6355840001Medicare NSC
FLCK947XMedicare PIN