MEDICARE: MRS. CHERI MARIE JROLF DMSC, PA-C

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	363AM0700X	Medical Physician Assistant	PA9102012	FL
2	363A00000X	Physician Assistant	PA9102012	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649368556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERI MARIE JROLF DMSC, PA-C

Provider Business Mailing Address
First Line	:	824 MANNS HARBOR DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-3393
Country	:	US
Telephone Number	:	941-350-4545
Fax Number	:	813-655-1775

Provider Business Practice Location Address
First Line	:	6421 N FLORIDA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-6007
Country	:	US
Telephone Number	:	813-244-5530
Fax Number	:	813-807-3391

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	11/04/2024

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