Healthcare Provider Details

I. General information

NPI: 1215072681
Provider Name (Legal Business Name): JOSEPH EDWARD CHERIES PSY. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 02/24/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 MDOS/SGOW 1370 SOUTH PATRICK DRIVE
PATRICK AFB FL
32925
US

IV. Provider business mailing address

45 OMRS/SGXW 1370 SOUTH PATRICK DRIVE
PATRICK SFB FL
32925
US

V. Phone/Fax

Practice location:
  • Phone: 321-494-8234
  • Fax:
Mailing address:
  • Phone: 321-494-8234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY 7389
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: