Provider Demographics
NPI:1245502434
Name:GRANT, SHARON MARCIA
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MARCIA
Last Name:GRANT
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 1:18260 NE 19TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1632
Mailing Address - Country:US
Mailing Address - Phone:305-956-9062
Mailing Address - Fax:
Practice Address - Street 1:18260 NE 19TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1632
Practice Address - Country:US
Practice Address - Phone:305-956-9062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9173756363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily