Provider Demographics
NPI:1720261472
Name:GERGIS, SHERRY LABIB (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LABIB
Last Name:GERGIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 2021
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1409
Mailing Address - Country:US
Mailing Address - Phone:330-412-8187
Mailing Address - Fax:
Practice Address - Street 1:1301 S INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 2021
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1409
Practice Address - Country:US
Practice Address - Phone:330-412-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1167562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH57.014209OtherTRAINING CERTIFICATE NUMB