Basic Information
| Provider Information | |||||||||
| NPI: | 1437265899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | SUNITA | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 LINTON BLVD STE 250 | ||||||||
| Address2: | 250 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334456600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612772369 | ||||||||
| FaxNumber: | 5614238579 | ||||||||
| Practice Location | |||||||||
| Address1: | 4600 LINTON BLVD STE 250 | ||||||||
| Address2: | 250 | ||||||||
| City: | DELRAY BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334456600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612772369 | ||||||||
| FaxNumber: | 5614238579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2006 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT14072 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 020150500 | 05 | FL | MEDICAID |