MEDICARE: CHERMIKA DORESTE BSW

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952702029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERMIKA DORESTE BSW

Provider Business Mailing Address
First Line	:	7621 LITTLE RD STE 200
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-5533
Country	:	US
Telephone Number	:	727-686-9247
Fax Number	:

Provider Business Practice Location Address
First Line	:	7621 LITTLE RD STE 200
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34654-5533
Country	:	US
Telephone Number	:	727-686-9247
Fax Number	:

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

Provider Enumeration Date	:	09/09/2014
Last Update Date	:	09/09/2014

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