Provider Demographics
NPI:1710366406
Name:GARRY, SHARON (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:GARRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:GRONO-GARRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:13670 WALSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3532
Mailing Address - Country:US
Mailing Address - Phone:727-593-9848
Mailing Address - Fax:727-596-4532
Practice Address - Street 1:13670 WALSINGHAM RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3532
Practice Address - Country:US
Practice Address - Phone:727-593-9848
Practice Address - Fax:727-596-4532
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109187363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017370000Medicaid
FL017370000Medicaid
HI017370000Medicaid
FLIR569YMedicare PIN
FLIR569ZMedicare PIN