Provider Demographics
NPI:1740687672
Name:ANDRASSI, SHARON LEE (RTR, CI ARRT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:ANDRASSI
Suffix:
Gender:F
Credentials:RTR, CI ARRT
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:LEE
Other - Last Name:RAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:336 CRESTFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-7469
Mailing Address - Country:US
Mailing Address - Phone:850-777-4888
Mailing Address - Fax:
Practice Address - Street 1:336 CRESTFIELD CIR
Practice Address - Street 2:
Practice Address - City:CANTONMENT
Practice Address - State:FL
Practice Address - Zip Code:32533-7469
Practice Address - Country:US
Practice Address - Phone:850-777-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177512471C1106X
MT47302471C1106X
DE79212471C1106X
TX1012852471C1106X
AZ172262471C1106X
FL344262471C1106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiac-Interventional Technology