Provider Demographics
NPI:1881226025
Name:CARRASQUILLO, SHERI SHUNTEL (CNA)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:SHUNTEL
Last Name:CARRASQUILLO
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4927
Mailing Address - Country:US
Mailing Address - Phone:772-672-2033
Mailing Address - Fax:
Practice Address - Street 1:1511 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4927
Practice Address - Country:US
Practice Address - Phone:772-672-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL334309376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide