Healthcare Provider Details

I. General information

NPI: 1669564241
Provider Name (Legal Business Name): SHERYL M HAYNES D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26750 US HIGHWAY 19 N STE 100
CLEARWATER FL
33761-3404
US

IV. Provider business mailing address

26750 US HIGHWAY 19 N STE 100
CLEARWATER FL
33761-3404
US

V. Phone/Fax

Practice location:
  • Phone: 727-726-1460
  • Fax: 727-724-9705
Mailing address:
  • Phone: 727-726-1460
  • Fax: 727-724-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS4234
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberOS4234
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: