MEDICARE: CHARITE D CHERY

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	247200000X	Other Technician		FL

General Provider Information

NPI Number	:	1174028278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITE D CHERY

Provider Business Mailing Address
First Line	:	1928 MERRY PL APT 103
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6322
Country	:	US
Telephone Number	:	561-631-4384
Fax Number	:

Provider Business Practice Location Address
First Line	:	1928 MERRY PL APT 103
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6322
Country	:	US
Telephone Number	:	561-631-4384
Fax Number	:

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

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	03/29/2018

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Directions to “ CHARITE D CHERY ” Practice Location

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