Provider Demographics
NPI:1720008436
Name:JEFFRIES, CHERYL L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L
Last Name:JEFFRIES
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 1:1717 N E ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6339
Mailing Address - Country:US
Mailing Address - Phone:850-437-8637
Mailing Address - Fax:850-437-8629
Practice Address - Street 1:1717 N E ST
Practice Address - Street 2:SUITE 222
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6339
Practice Address - Country:US
Practice Address - Phone:850-437-8637
Practice Address - Fax:850-437-8629
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33594207R00000X
FLME115074207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008376300Medicaid
NC894587AMedicaid
FLHB593ZMedicare PIN
NCE80531Medicare UPIN
FL008376300Medicaid