Provider Demographics
NPI:1467515361
Name:CHERVONY, DANIEL ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ENRIQUE
Last Name:CHERVONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7431 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2956
Mailing Address - Country:US
Mailing Address - Phone:954-720-7999
Mailing Address - Fax:954-720-5335
Practice Address - Street 1:7431 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2956
Practice Address - Country:US
Practice Address - Phone:954-720-7999
Practice Address - Fax:954-720-5335
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME517872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0050424OtherGHI
FL07597OtherBLUE CROSS & BLUE SHEILD
FL07597OtherBLUE CROSS & BLUE SHEILD
FLE30533Medicare UPIN