Provider Demographics
NPI:1811092851
Name:KNIBBS, SHARANE (BA)
Entity type:Individual
Prefix:MS
First Name:SHARANE
Middle Name:
Last Name:KNIBBS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:SHARANE
Other - Middle Name:
Other - Last Name:KNIBBS-RHONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:3415 FOXCROFT RD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4186
Mailing Address - Country:US
Mailing Address - Phone:954-432-1114
Mailing Address - Fax:
Practice Address - Street 1:15490 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6250
Practice Address - Country:US
Practice Address - Phone:305-685-0381
Practice Address - Fax:305-687-8747
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management