Provider Demographics
NPI:1457068082
Name:SHARIFI, SHIRA (CBD, CPD, NCS, CBS)
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:
Last Name:SHARIFI
Suffix:
Gender:F
Credentials:CBD, CPD, NCS, CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 SARGO RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32233-3816
Mailing Address - Country:US
Mailing Address - Phone:516-413-7830
Mailing Address - Fax:
Practice Address - Street 1:428 SARGO RD
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:FL
Practice Address - Zip Code:32233-3816
Practice Address - Country:US
Practice Address - Phone:516-413-7830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula