Provider Demographics
NPI:1760890065
Name:ROUSE, CHERYL HARRIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:HARRIS
Last Name:ROUSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 S GOLDWYN AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-4324
Mailing Address - Country:US
Mailing Address - Phone:407-295-6201
Mailing Address - Fax:
Practice Address - Street 1:927 S GOLDWYN AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-4324
Practice Address - Country:US
Practice Address - Phone:407-295-6201
Practice Address - Fax:407-295-0306
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist