Provider Demographics
NPI:1528335346
Name:ROME, CHERIE ANN (APRN)
Entity type:Individual
Prefix:
First Name:CHERIE
Middle Name:ANN
Last Name:ROME
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHERIE
Other - Middle Name:ROME
Other - Last Name:ROXBURGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-728-6072
Mailing Address - Fax:
Practice Address - Street 1:7000 SPYGLASS CT STE 200
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7948
Practice Address - Country:US
Practice Address - Phone:321-728-6072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2615482363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFY237WOtherMEDICARE
FLP02074517OtherFL RR