Provider Demographics
NPI:1548691512
Name:BAUMER, CHERRYL
Entity type:Individual
Prefix:
First Name:CHERRYL
Middle Name:
Last Name:BAUMER
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 1:1611 NW 12TH AVE
Mailing Address - Street 2:INSTITUTE BUILDING ROOM 335
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-585-8980
Mailing Address - Fax:305-355-2274
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:INSTITUTE BUILDING ROOM 335
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-8980
Practice Address - Fax:305-355-2274
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2008772174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator