MEDICARE: SHERYL L ADAMS PH.D.

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	103TC0700X	Clinical Psychologist	PY4450	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BLUE CROSS/BLUE SHIE	OTHER	FL	73791

General Provider Information

NPI Number	:	1982667739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL L ADAMS PH.D.

Provider Business Mailing Address
First Line	:	2039 N MERIDIAN RD
Second Line	:	APT. 175
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5073
Country	:	US
Telephone Number	:	850-894-0067
Fax Number	:	850-894-0062

Provider Business Practice Location Address
First Line	:	1290 NW HONEY LAKE RD
Second Line	:
City	:	GREENVILLE
State	:	FL
Zip	:	32331-4075
Country	:	US
Telephone Number	:	954-536-9539
Fax Number	:	954-719-6762

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	04/28/2017

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