MEDICARE: MS. HEATHER MICHELLE CHERRY MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1194961268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER MICHELLE CHERRY MSW

Provider Business Mailing Address
First Line	:	6705 SW 137TH CT # 13B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2292
Country	:	US
Telephone Number	:	786-457-6788
Fax Number	:

Provider Business Practice Location Address
First Line	:	6705 SW 137TH CT # 13B
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2292
Country	:	US
Telephone Number	:	786-457-6788
Fax Number	:

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

Provider Enumeration Date	:	12/19/2008
Last Update Date	:	12/19/2008

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