Provider Demographics
NPI:1194845362
Name:CHERELUS, MAX (CRTT)
Entity Type:Individual
Prefix:
First Name:MAX
Middle Name:
Last Name:CHERELUS
Suffix:
Gender:M
Credentials:CRTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SW 49TH TER
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-3123
Mailing Address - Country:US
Mailing Address - Phone:954-956-8279
Mailing Address - Fax:
Practice Address - Street 1:801 SW 49TH TER
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-3123
Practice Address - Country:US
Practice Address - Phone:954-956-8279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT 12145227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified