Provider Demographics
NPI:1801074570
Name:CHERYL YELVERTON MD PA
Entity type:Organization
Organization Name:CHERYL YELVERTON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MCC
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:YELVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-835-2788
Mailing Address - Street 1:201 NW 82ND AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7808
Mailing Address - Country:US
Mailing Address - Phone:954-835-2788
Mailing Address - Fax:954-430-4362
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:954-835-2788
Practice Address - Fax:954-430-4362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAT933Medicare PIN