Basic Information
Provider Information
NPI: 1023303278
EntityType: 2
ReplacementNPI:  
OrganizationName: PRIXIT SHARMA INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 1005 W CIRCLE ST
Address2:  
City: AVON PARK
State: FL
PostalCode: 338252928
CountryCode: US
TelephoneNumber: 8634535500
FaxNumber:  
Practice Location
Address1: 1005 W CIRCLE ST
Address2:  
City: AVON PARK
State: FL
PostalCode: 338252928
CountryCode: US
TelephoneNumber: 8634535500
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/16/2011
LastUpdateDate: 06/16/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: SHARMA
AuthorizedOfficialFirstName: PRIXIT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 8634535500
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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