Healthcare Provider Details

I. General information

NPI: 1043207293
Provider Name (Legal Business Name): SHERRIE LENISE BULLARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERRIE LENISE BULLARD LEMON M.D.

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

IV. Provider business mailing address

PO BOX 848098
PEMBROKE PINES FL
33084-0098
US

V. Phone/Fax

Practice location:
  • Phone: 877-463-2010
  • Fax: 954-961-8876
Mailing address:
  • Phone: 954-689-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME75847
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: