Provider Demographics
NPI:1194246181
Name:PERKINS, SHERONDA LATRICE
Entity type:Individual
Prefix:
First Name:SHERONDA
Middle Name:LATRICE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3399 WOODBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-7566
Mailing Address - Country:US
Mailing Address - Phone:850-408-8822
Mailing Address - Fax:850-765-3074
Practice Address - Street 1:3399 WOODBRIAR LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-7566
Practice Address - Country:US
Practice Address - Phone:850-408-8822
Practice Address - Fax:850-765-3074
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health