Healthcare Provider Details

I. General information

NPI: 1568687309
Provider Name (Legal Business Name): ANNA SHERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 SW 104TH ST
MIAMI FL
33176-8162
US

IV. Provider business mailing address

400 ALTON RD APT. # 711
MIAMI BEACH FL
33139-6702
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-7883
  • Fax: 305-274-4271
Mailing address:
  • Phone: 305-274-7883
  • Fax: 305-274-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 6986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: