Provider Demographics
NPI:1497786875
Name:BIENIEK, SHERRIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:ANN
Last Name:BIENIEK
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 1:9995 SW 72ND ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4662
Mailing Address - Country:US
Mailing Address - Phone:305-412-6034
Mailing Address - Fax:305-412-6686
Practice Address - Street 1:9995 SW 72ND ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4662
Practice Address - Country:US
Practice Address - Phone:305-412-6034
Practice Address - Fax:305-412-6686
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00658102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251096100Medicaid
FLG34752Medicare UPIN
FL251096100Medicaid