Provider Demographics
NPI:1104827229
Name:ASHBERG, SHERRYL A (MD)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:A
Last Name:ASHBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:601 UNIVERSITY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2788
Practice Address - Country:US
Practice Address - Phone:561-747-5066
Practice Address - Fax:561-746-3770
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271779400Medicaid
FL271779400Medicaid
52110ZMedicare ID - Type Unspecified