Healthcare Provider Details

I. General information

NPI: 1992970883
Provider Name (Legal Business Name): SHERYL A BOOHER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 N STONE ST STE 206
DELAND FL
32720-3208
US

IV. Provider business mailing address

15280 NW 79TH CT STE 200
MIAMI LAKES FL
33016-5873
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-7192
  • Fax:
Mailing address:
  • Phone: 305-558-3372
  • Fax: 786-907-4485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1860
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: