Provider Demographics
NPI:1770507121
Name:SURLOFF, CHERI GAY (PHD,PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHERI
Middle Name:GAY
Last Name:SURLOFF
Suffix:
Gender:F
Credentials:PHD,PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PALM DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6533
Mailing Address - Country:US
Mailing Address - Phone:954-456-7429
Mailing Address - Fax:954-456-0949
Practice Address - Street 1:501 PALM DR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6533
Practice Address - Country:US
Practice Address - Phone:954-456-7429
Practice Address - Fax:954-456-0949
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5918103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL577317Medicare UPIN