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NPI Code Detail

MEDICARE: CHERYL LAVERN HOLDER M.D.

MEDICARE: CHERYL LAVERN HOLDER M.D.
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
1207R00000XInternal Medicine PhysicianME51226FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780626820
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL LAVERN HOLDER M.D.
Provider Business Mailing Address
First Line : 10300 SW 216TH ST
Second Line :
City : CUTLER BAY
State : FL
Zip : 33190-1003
Country : US
Telephone Number : 305-253-5100
Fax Number :
Provider Business Practice Location Address
First Line : 10300 SW 216TH ST
Second Line :
City : CUTLER BAY
State : FL
Zip : 33190-1003
Country : US
Telephone Number : 305-253-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 10/04/2024

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