Provider Demographics
NPI:1881902070
Name:HELLER, SHARON L (LMT)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:HELLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 NW 41ST ST. SUITE E-6
Mailing Address - Street 2:#106
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:561-330-2929
Mailing Address - Fax:
Practice Address - Street 1:2631 NW 41ST ST STE E6
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6689
Practice Address - Country:US
Practice Address - Phone:561-243-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59117225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist