Provider Demographics
NPI:1063966166
Name:SHARPE, MELISA (AUD)
Entity type:Individual
Prefix:
First Name:MELISA
Middle Name:
Last Name:SHARPE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 A1A N STE 100
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-5701
Mailing Address - Country:US
Mailing Address - Phone:904-501-2280
Mailing Address - Fax:855-527-7300
Practice Address - Street 1:166 A1A N STE 100
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-5701
Practice Address - Country:US
Practice Address - Phone:904-501-2280
Practice Address - Fax:855-527-7300
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1214231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist