Provider Demographics
NPI:1790813012
Name:KEEFE, SHARON A (OTR)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:KEEFE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 694
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-0694
Mailing Address - Country:US
Mailing Address - Phone:561-736-8380
Mailing Address - Fax:561-752-8528
Practice Address - Street 1:3301 W BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE #2
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4642
Practice Address - Country:US
Practice Address - Phone:561-736-8380
Practice Address - Fax:561-752-8528
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT0001313225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7433OtherBCBS ID
FLE2166ZMedicare PIN