Provider Demographics
NPI:1487614491
Name:SHARF, LISA (MSN, PSMHNP-CS ANP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SHARF
Suffix:
Gender:F
Credentials:MSN, PSMHNP-CS ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 EDGEWATER DR
Mailing Address - Street 2:#514
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133
Mailing Address - Country:US
Mailing Address - Phone:786-356-9342
Mailing Address - Fax:305-667-7839
Practice Address - Street 1:2000 S DIXIE HWY
Practice Address - Street 2:#104
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-2456
Practice Address - Country:US
Practice Address - Phone:786-356-9342
Practice Address - Fax:305-667-7839
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1190912163WP0808X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303550600Medicaid
FL303550600Medicaid
P29514Medicare UPIN