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General NPI Number Information
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NPI Number | 1497867592
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Entity Type | Individual
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Provider Name | CHERRY EVON CARLIS R.D., LD/N
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-324-4455
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Fax |
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Provider Business Mailing Address
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Address Line | 20170 NW 9TH DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3422
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Country | US
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Telephone | 954-433-0611
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND 922
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License Number State | FL
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