Healthcare Provider Details

I. General information

NPI: 1790785707
Provider Name (Legal Business Name): SHERRI FAIR CAPLAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERRI LYNN FAIR DO

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 VIDINA DR
MELBOURNE FL
32940-7698
US

IV. Provider business mailing address

3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US

V. Phone/Fax

Practice location:
  • Phone: 321-471-1068
  • Fax: 321-434-9285
Mailing address:
  • Phone: 321-868-2778
  • Fax: 321-951-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS8369
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: