| |
9011 Park Blvd Ste 209, Seminole, FL 33777-4123 | |
(727) 596-4878 | |
(727) 213-6701 |
Full Name | |
---|---|
Type | Facility |
Speciality | Nurse Practitioner |
Location | 9011 Park Blvd Ste 209, Seminole, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538317722 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Sean L Sharp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740341494 PECOS PAC ID: 1850585928 Enrollment ID: I20201214000451 |
Mailing Address | Practice Location Address |
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9011 Park Blvd Ste 209, Seminole, FL 33777-4123 Ph: (727) 596-4878 | 9011 Park Blvd Ste 209, Seminole, FL 33777-4123 Ph: (727) 596-4878 |