Provider Demographics
NPI:1669806733
Name:SHROFF, SHARMILA G
Entity type:Individual
Prefix:
First Name:SHARMILA
Middle Name:G
Last Name:SHROFF
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 1:7907 SAILBOAT KEY BLVD S
Mailing Address - Street 2:UNIT 208
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-6368
Mailing Address - Country:US
Mailing Address - Phone:727-360-5093
Mailing Address - Fax:
Practice Address - Street 1:7907 SAILBOAT KEY BLVD S
Practice Address - Street 2:UNIT 208
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-6368
Practice Address - Country:US
Practice Address - Phone:727-360-5093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11282101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor