Provider Demographics
NPI:1801052972
Name:PROTAS, CHERYL (LMT)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:PROTAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14823 CUMBERLAND DR APT 105M
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1320
Mailing Address - Country:US
Mailing Address - Phone:561-455-4209
Mailing Address - Fax:561-455-2406
Practice Address - Street 1:14823 CUMBERLAND DR APT 105M
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1320
Practice Address - Country:US
Practice Address - Phone:561-455-4209
Practice Address - Fax:561-455-2406
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA12102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1801052972OtherINSURANCE