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General NPI Number Information
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NPI Number | 1396924684
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Entity Type | Individual
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Provider Name | CHERYL EILEEN DESMARAIS ARNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 10000 BAY PINES BLVD (116C)
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City | BAY PINES
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State | FL
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Zip | 33744-5005
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Country | US
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Telephone | 727-398-6661
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Fax | 727-319-1240
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Provider Business Mailing Address
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Address Line | 12520 83RD AVE
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City | SEMINOLE
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State | FL
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Zip | 33776-3217
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Country | US
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Telephone | 727-319-4174
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1648222 ARNP
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License Number State | FL
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