Healthcare Provider Details

I. General information

NPI: 1588649479
Provider Name (Legal Business Name): CHERYLLE A HAYES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 W NEWBERRY RD
GAINESVILLE FL
32605-6621
US

IV. Provider business mailing address

PO BOX 143067
GAINESVILLE FL
32614-3067
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-5840
  • Fax: 352-333-5841
Mailing address:
  • Phone: 352-333-5840
  • Fax: 352-333-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberFLME68845
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberFLME68845
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: