Provider Demographics
NPI:1588649479
Name:HAYES, CHERYLLE A (MD)
Entity type:Individual
Prefix:
First Name:CHERYLLE
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 143067
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-3067
Mailing Address - Country:US
Mailing Address - Phone:352-333-5840
Mailing Address - Fax:352-333-5844
Practice Address - Street 1:6420 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6621
Practice Address - Country:US
Practice Address - Phone:352-333-5840
Practice Address - Fax:352-333-5841
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLME68845174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379563200Medicaid
FL001827838OtherUNITED HEALTHCARE
FL238479OtherAVMED
FL28915OtherBLUE CROSS BLUE SHIELD
FL28915UMedicare PIN
FL379563200Medicaid