Provider Demographics
NPI:1023137130
Name:BARNES, CHERYL KAY
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:KAY
Last Name:BARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHERYL
Other - Middle Name:KAY
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:2114 NW 55TH BLVD
Mailing Address - Street 2:# 10
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-2187
Mailing Address - Country:US
Mailing Address - Phone:352-337-0586
Mailing Address - Fax:
Practice Address - Street 1:5021 NW 34TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6121
Practice Address - Country:US
Practice Address - Phone:352-377-3322
Practice Address - Fax:352-377-5300
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0011017225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist