Healthcare Provider Details

I. General information

NPI: 1316940810
Provider Name (Legal Business Name): YVONNE ROBERTA SMALLWOOD SHERRER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 N. DIXIE HIGHWAY #110
FT. LAUDERDALE FL
33334
US

IV. Provider business mailing address

5333 N. DIXIE HIGHWAY #110
FT. LAUDERDALE FL
33334
US

V. Phone/Fax

Practice location:
  • Phone: 954-229-7030
  • Fax: 954-229-2430
Mailing address:
  • Phone: 954-229-7030
  • Fax: 954-229-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME0047078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: