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General NPI Number Information
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NPI Number | 1619524535
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Entity Type | Individual
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Provider Name | ERILIEN CHERILUS PA
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Gender | Male
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 714 SUNNY PINE WAY APT A1
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City | GREENACRES
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State | FL
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Zip | 33415-8972
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Country | US
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Telephone | 561-460-1254
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Fax |
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Provider Business Mailing Address
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Address Line | 6514 SPRING MEADOW DR
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City | GREENACRES
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State | FL
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Zip | 33413-3477
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Country | US
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Telephone | 561-460-1254
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 19-208
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2112-P.A.
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License Number State | PR
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