Provider Demographics
NPI:1588107387
Name:JEFFRIES, SHARON A
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-3209
Mailing Address - Country:US
Mailing Address - Phone:352-875-1041
Mailing Address - Fax:352-360-0024
Practice Address - Street 1:2808 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3209
Practice Address - Country:US
Practice Address - Phone:352-875-1041
Practice Address - Fax:352-360-0024
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234612251E00000X
FL236031251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health