Provider Demographics
NPI:1740341494
Name:SHARP, SEAN (DC, APRN, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:DC, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9011 PARK BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4123
Mailing Address - Country:US
Mailing Address - Phone:727-596-4878
Mailing Address - Fax:727-213-6701
Practice Address - Street 1:9011 PARK BLVD STE 209
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4123
Practice Address - Country:US
Practice Address - Phone:727-596-4878
Practice Address - Fax:727-213-6701
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9313111N00000X
FL11007814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEA692ZOtherMEDICARE PTAN