MEDICARE: MR. JEAN D CHERFILS LMT

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	225700000X	Massage Therapist	MA58553	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8894	OTHER	FL	IRS

General Provider Information

NPI Number	:	1982133013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEAN D CHERFILS LMT

Provider Business Mailing Address
First Line	:	145 NE 78TH ST APT 508
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-5087
Country	:	US
Telephone Number	:	305-761-6725
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 NE 78TH ST APT 508
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33138-5087
Country	:	US
Telephone Number	:	305-761-3725
Fax Number	:

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

Provider Enumeration Date	:	06/12/2017
Last Update Date	:	06/12/2017

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