Healthcare Provider Details

I. General information

NPI: 1124040571
Provider Name (Legal Business Name): CHERYL BERNITA BARGE-SEABROOKS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2181 ORANGE AVE E
TALLAHASSEE FL
32311-6144
US

IV. Provider business mailing address

8361 FORDHAM LN
TALLAHASSEE FL
32305-1303
US

V. Phone/Fax

Practice location:
  • Phone: 850-513-7396
  • Fax: 850-513-8013
Mailing address:
  • Phone: 850-933-0264
  • Fax: 850-513-8013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17409
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number17409
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: