Provider Demographics
NPI:1902677073
Name:GERSHGORIN, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:GERSHGORIN
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 1:2000 S OCEAN DR UNIT 17B
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6890
Mailing Address - Country:US
Mailing Address - Phone:305-988-6099
Mailing Address - Fax:
Practice Address - Street 1:2000 S OCEAN DR UNIT 17B
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6890
Practice Address - Country:US
Practice Address - Phone:305-988-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA22132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist