Provider Demographics
NPI:1932171055
Name:SMITH-THOMAS, SHARON (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SMITH-THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 GLADES RD STE 340
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6468
Mailing Address - Country:US
Mailing Address - Phone:561-488-1801
Mailing Address - Fax:561-451-1480
Practice Address - Street 1:660 GLADES RD STE 340
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6468
Practice Address - Country:US
Practice Address - Phone:561-488-1801
Practice Address - Fax:561-451-1480
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2004-0827207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM202000066OtherPRESBYTERIAN HEALTH/SALUD
NM60053771Medicaid
AZ952756Medicaid
FL00551OtherBCBS
NM10019725OtherLOVELACE HEALTH/SALUD
NMQMYPR0068275OtherMOLINA
FL00551OtherBCBS
AZ952756Medicaid
345529006Medicare ID - Type Unspecified