Provider Demographics
NPI:1356342786
Name:SHARP, ELAINE C (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:C
Last Name:SHARP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:C
Other - Last Name:ARBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1395 EL RITO DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-6707
Mailing Address - Country:US
Mailing Address - Phone:850-733-9343
Mailing Address - Fax:850-733-9446
Practice Address - Street 1:1395 EL RITO DR
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-6707
Practice Address - Country:US
Practice Address - Phone:850-733-9343
Practice Address - Fax:850-733-9446
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036107352207V00000X
FL55013207V00000X
FLME55013207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010815000Medicaid
ILD35264Medicare UPIN
IL036107352Medicaid