MEDICARE: MRS. CHERYL LEE SALDATE ARDMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1134326473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHERYL LEE SALDATE ARDMS

Provider Business Mailing Address
First Line	:	1261 BAY HARBOR DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2490
Country	:	US
Telephone Number	:	813-787-6145
Fax Number	:

Provider Business Practice Location Address
First Line	:	3687 TAMPA ROAD
Second Line	:	SUITE 202
City	:	PALM HARBOR
State	:	FL
Zip	:	34677
Country	:	US
Telephone Number	:	813-814-2229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	07/08/2007

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