Provider Demographics
NPI:1922295708
Name:SHARPE, WINSOME IVERENE (BA)
Entity Type:Individual
Prefix:MRS
First Name:WINSOME
Middle Name:IVERENE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 N HARBOR CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-6572
Mailing Address - Country:US
Mailing Address - Phone:321-259-8928
Mailing Address - Fax:321-259-6060
Practice Address - Street 1:1495 N HARBOR CITY BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6572
Practice Address - Country:US
Practice Address - Phone:321-259-8928
Practice Address - Fax:321-259-6060
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator