Basic Information
| Provider Information | |||||||||
| NPI: | 1275528804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | NAGARAJA | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21727 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336221727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278628383 | ||||||||
| FaxNumber: | 7278634766 | ||||||||
| Practice Location | |||||||||
| Address1: | 7614 JACQUE RD | ||||||||
| Address2: | STE C | ||||||||
| City: | HUDSON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346677195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278628383 | ||||||||
| FaxNumber: | 7278681130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2005 | ||||||||
| LastUpdateDate: | 02/27/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME90342 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 270189800 | 05 | FL | MEDICAID | 46095 | 01 | FL | BCBS | OTHER | P00179067 | 01 | RRW MCR | OTHER |