Provider Demographics
NPI:1205081387
Name:CAREY, SHARON L
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:CAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8121 CHAMPIONS CIR
Mailing Address - Street 2:APT 304
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-9623
Mailing Address - Country:US
Mailing Address - Phone:302-507-3431
Mailing Address - Fax:
Practice Address - Street 1:8121 CHAMPIONS CIR
Practice Address - Street 2:APT 304
Practice Address - City:CHAMPIONS GATE
Practice Address - State:FL
Practice Address - Zip Code:33896-9623
Practice Address - Country:US
Practice Address - Phone:302-507-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23309225200000X
DEMT-0002630225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist