Provider Demographics
NPI:1386874709
Name:CARREON SANCHEZ, CHERIL EVANGELISTA (PT)
Entity type:Individual
Prefix:
First Name:CHERIL
Middle Name:EVANGELISTA
Last Name:CARREON SANCHEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHERIL
Other - Middle Name:CARREON
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11950 WYNNFIELD LAKES CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-4232
Mailing Address - Country:US
Mailing Address - Phone:562-606-7515
Mailing Address - Fax:
Practice Address - Street 1:10660 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-1076
Practice Address - Country:US
Practice Address - Phone:904-268-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist