Provider Demographics
NPI:1346456365
Name:LUCAS ANTHONY, CHERE ROSHALL (MD)
Entity Type:Individual
Prefix:
First Name:CHERE
Middle Name:ROSHALL
Last Name:LUCAS ANTHONY
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 1:4479 COLLINS
Mailing Address - Street 2:# 2201
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-458-0802
Mailing Address - Fax:786-768-2017
Practice Address - Street 1:4779 COLLINS AVE
Practice Address - Street 2:2201
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3251
Practice Address - Country:US
Practice Address - Phone:305-774-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2009-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98172207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology