Provider Demographics
NPI:1861087611
Name:RIVERS, SHARRKHAN
Entity type:Individual
Prefix:
First Name:SHARRKHAN
Middle Name:
Last Name:RIVERS
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 1:2800 LAKEVIEW TER APT 201
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4920
Mailing Address - Country:US
Mailing Address - Phone:754-249-3605
Mailing Address - Fax:954-827-8304
Practice Address - Street 1:2800 LAKEVIEW TER APT 201
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4920
Practice Address - Country:US
Practice Address - Phone:754-249-3605
Practice Address - Fax:954-827-8304
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician