MOHAN L SHARMA MD PA
Suppliers at Rich Ave, Deland, FL

License number
Florida ME66293
Category
Suppliers
Type
Non-Pharmacy Dispensing Site
Owner
Name: KENNY HEINE
Title: VP OF OPERATIONS
Phone: (858) 964-1506
Address
Address 2
229 E Rich Ave, Deland, FL 32724
5626 Oberlin Dr SUITE 110, San Diego, CA 92121
National Provider ID: 1891124988
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about MOHAN L SHARMA MD PA at bizstanding.com

MOHAN L. SHARMA M.D., PA

Deland, FL

Status:
Inactive
Inactive reason:
Reinstatement
Registration:
Jun 5, 2006
Inactive since:
Oct 16, 2013
Addresses:
229 E Rich Ave, Deland, FL 32724 (Physical)
231 E Rich Ave, Deland, FL 32724
State ID:
P06000076880
Business type:
Florida Profit Corporation
Treasurer, Secretarys:
Mohan L Sharma (President, Vice President), 1658 Sterling Silver Blvd, Deltona, FL 32725 (Physical),Kiran P Sharma (Treasurer, Secretary), 1658 Sterling Silver Blvd, Deltona, FL 32725 (Physical)
Agent:
Mohan Sharma,1658 Sterling Silver Blvd, Deltona, FL 32725 (Physical)
EIN:
20-4977043

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