Provider Demographics
NPI:1760570626
Name:PATTERSON, SHARLA GAYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARLA
Middle Name:GAYLE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHARLA
Other - Middle Name:GAYLE
Other - Last Name:WARTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11181 HEALTH PARK BLVD STE 1115
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5742
Mailing Address - Country:US
Mailing Address - Phone:239-758-7465
Mailing Address - Fax:
Practice Address - Street 1:3530 KRAFT RD STE 202
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5020
Practice Address - Country:US
Practice Address - Phone:239-758-7465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062152208600000X
AL27211208600000X
FLME115033208600000X
MS21116208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGZ682YOtherMEDICARE
MS01079230Medicaid
FL008212100Medicaid
AL124594Medicaid
FL14P6COtherBCBS
MSP01212501OtherRAILROAD MEDICARE
MS302I025423Medicare PIN
AL102G704822Medicare PIN
FL008212100Medicaid