Provider Demographics
NPI:1275793820
Name:SHER, JANELLE MARA (MD)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:MARA
Last Name:SHER
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 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:954-965-7400
Mailing Address - Fax:305-935-6146
Practice Address - Street 1:1801 NE 123RD ST
Practice Address - Street 2:SUITE 414
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2817
Practice Address - Country:US
Practice Address - Phone:954-965-7400
Practice Address - Fax:305-935-6146
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119468208000000X, 2080P0201X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012017100Medicaid