Provider Demographics
NPI:1649368556
Name:JROLF, CHERI MARIE (DMSC, PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:MARIE
Last Name:JROLF
Suffix:
Gender:F
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 MANNS HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3393
Mailing Address - Country:US
Mailing Address - Phone:941-350-4545
Mailing Address - Fax:813-655-1775
Practice Address - Street 1:6421 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-6007
Practice Address - Country:US
Practice Address - Phone:813-244-5530
Practice Address - Fax:813-807-3391
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102012363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4219T-PASCOMedicare PIN
FLU4219S- HILLSBOROUGHMedicare PIN
FLP01727379-RAILROADMedicare PIN
FLS46856Medicare UPIN