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General NPI Number Information
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NPI Number | 1386874709
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Entity Type | Individual
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Provider Name | CHERIL EVANGELISTA CARREON SANCHEZ P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 10660 OLD SAINT AUGUSTINE RD
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City | JACKSONVILLE
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State | FL
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Zip | 32257-1076
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Country | US
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Telephone | 904-268-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 11950 WYNNFIELD LAKES CIR
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City | JACKSONVILLE
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State | FL
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Zip | 32246-4232
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Country | US
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Telephone | 562-606-7515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24699
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License Number State | FL
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