Provider Demographics
NPI:1528238482
Name:SHAROVA, VALERIYA Y (MD)
Entity type:Individual
Prefix:
First Name:VALERIYA
Middle Name:Y
Last Name:SHAROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 S CONGRESS AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6625
Mailing Address - Country:US
Mailing Address - Phone:561-964-7511
Mailing Address - Fax:561-964-7544
Practice Address - Street 1:2201 45TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2047
Practice Address - Country:US
Practice Address - Phone:561-964-7511
Practice Address - Fax:561-964-7544
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL112732084P0800X
FLME1123282084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007141700Medicaid
FL007141700Medicaid