Provider Demographics
NPI:1306657929
Name:THOMAS, CHERELLE A (CPT1)
Entity type:Individual
Prefix:
First Name:CHERELLE
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CPT1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 COLLEGE PKWY # 622
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2711
Mailing Address - Country:US
Mailing Address - Phone:404-447-6279
Mailing Address - Fax:972-767-3970
Practice Address - Street 1:1333 COLLEGE PKWY # 622
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2711
Practice Address - Country:US
Practice Address - Phone:404-447-6279
Practice Address - Fax:972-767-3970
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT-00069262246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty