Provider Demographics
NPI:1053323378
Name:ROYAL, CHERYLE
Entity Type:Individual
Prefix:MRS
First Name:CHERYLE
Middle Name:
Last Name:ROYAL
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 1:2050 OAK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8850
Mailing Address - Country:US
Mailing Address - Phone:904-422-2455
Mailing Address - Fax:904-379-6526
Practice Address - Street 1:2050 OAK GLEN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8850
Practice Address - Country:US
Practice Address - Phone:904-422-2455
Practice Address - Fax:904-379-6526
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230276376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker