Provider Demographics
NPI:1598788937
Name:SITAHAL, LORELLI SHARON (MD)
Entity Type:Individual
Prefix:DR
First Name:LORELLI
Middle Name:SHARON
Last Name:SITAHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 CONGRESS PARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4688
Mailing Address - Country:US
Mailing Address - Phone:561-279-0991
Mailing Address - Fax:561-279-0539
Practice Address - Street 1:200 CONGRESS PARK DR STE 210
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4688
Practice Address - Country:US
Practice Address - Phone:561-279-0991
Practice Address - Fax:561-279-0539
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88501173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268084000Medicaid