Healthcare Provider Details

I. General information

NPI: 1194560482
Provider Name (Legal Business Name): MARINA MICHELLE SHERRER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SE 24TH ST
GAINESVILLE FL
32641-7516
US

IV. Provider business mailing address

468 SW BURGUNDY LN
FORT WHITE FL
32038-5015
US

V. Phone/Fax

Practice location:
  • Phone: 352-334-7900
  • Fax: 352-334-7957
Mailing address:
  • Phone: 386-623-1048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN9362338
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: