Provider Demographics
NPI:1245275205
Name:BROOKS, CHERYLAN M (AUD)
Entity type:Individual
Prefix:DR
First Name:CHERYLAN
Middle Name:M
Last Name:BROOKS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:7593 BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6154
Practice Address - Country:US
Practice Address - Phone:561-742-9880
Practice Address - Fax:561-742-5990
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2310VOtherMEDICARE