Provider Demographics
NPI:1801572169
Name:RAGHOONANAN, SHARLENE ANJANIE (OD)
Entity type:Individual
Prefix:DR
First Name:SHARLENE
Middle Name:ANJANIE
Last Name:RAGHOONANAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-4310
Mailing Address - Country:US
Mailing Address - Phone:561-654-5565
Mailing Address - Fax:
Practice Address - Street 1:10201 HAGEN RANCH RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3758
Practice Address - Country:US
Practice Address - Phone:954-895-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6246152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist