MEDICARE: SHERYL TIMOL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN9291894	FL
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	APRN1104747	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APRN11004747	OTHER	FL	FLORIDA DOH

General Provider Information

NPI Number	:	1538710777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL TIMOL APRN

Provider Business Mailing Address
First Line	:	5827 CORPORATE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2000
Country	:	US
Telephone Number	:	561-844-9443
Fax Number	:	561-844-1013

Provider Business Practice Location Address
First Line	:	9576 S US HIGHWAY 1
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-4217
Country	:	US
Telephone Number	:	772-337-4000
Fax Number	:	844-543-0396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	04/10/2023

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Directions to “ SHERYL TIMOL APRN” Practice Location

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