Provider Demographics
NPI:1023412368
Name:SHARMA, RAVI (ARNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2352 OKALANI ST
Mailing Address - Street 2:
Mailing Address - City:PALM SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7300
Mailing Address - Country:US
Mailing Address - Phone:815-508-0600
Mailing Address - Fax:888-506-2822
Practice Address - Street 1:2352 OKALANI ST
Practice Address - Street 2:
Practice Address - City:PALM SHORES
Practice Address - State:FL
Practice Address - Zip Code:32940-7300
Practice Address - Country:US
Practice Address - Phone:815-508-0600
Practice Address - Fax:888-506-2822
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95008949363L00000X
FLARNP9378451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner