Provider Demographics
NPI:1659502243
Name:BIENERT, SHARON (L AC)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BIENERT
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:RUBY
Other - Middle Name:
Other - Last Name:BIENERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:122 SERENITY DR
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:FL
Mailing Address - Zip Code:32666-3032
Mailing Address - Country:US
Mailing Address - Phone:352-214-6555
Mailing Address - Fax:
Practice Address - Street 1:211 SW 4TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-1805
Practice Address - Country:US
Practice Address - Phone:352-214-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2619171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist