Provider Demographics
NPI:1598930588
Name:ALDRICH, SHARON S (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 OAKFIELD DR
Mailing Address - Street 2:STE A
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:813-689-7799
Mailing Address - Fax:
Practice Address - Street 1:915 OAKFIELD DR
Practice Address - Street 2:STE A
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4933
Practice Address - Country:US
Practice Address - Phone:813-689-7799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA41818225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist