Provider Demographics
NPI:1134225717
Name:STANLEY, CHERYL M (DC)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:M
Last Name:STANLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20079 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-6037
Mailing Address - Country:US
Mailing Address - Phone:352-489-2995
Mailing Address - Fax:352-465-4809
Practice Address - Street 1:20079 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-6037
Practice Address - Country:US
Practice Address - Phone:352-489-2995
Practice Address - Fax:352-465-4809
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL628931OtherUNITED HEALTHCARE
FL22851OtherBLUE CROSS BLUE SHIELD
FL35004303OtherRAILROAD MEDICARE
FL2031210OtherAETNA
FL240718OtherAVMED
FL22851OtherBLUE CROSS BLUE SHIELD
FL22851YMedicare ID - Type Unspecified