Provider Demographics
NPI:1720441637
Name:CHERRY, CHRISTINA BRIANNE (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:BRIANNE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 S ORLANDO DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5339
Mailing Address - Country:US
Mailing Address - Phone:407-200-0547
Mailing Address - Fax:
Practice Address - Street 1:2690 S ORLANDO DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5339
Practice Address - Country:US
Practice Address - Phone:407-200-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311144207Q00000X
390200000X
FLOS20378207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program