Individual provider · NPI-1

Cecil A. Cherian, M.D.

Family Medicine · Ruskin, FL

NPI number1396970950
StatusActive
Last updated in NPPESDec 15, 2016

Details

NPI
1396970950
Entity type
Individual (NPI-1)
Name
Cecil A. Cherian
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
May 26, 2009
Last updated
Dec 15, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineME113498FLYes
207Q00000X Family Medicine27027OK

Practice location

781 Cypress Village Blvd
Ruskin, FL 33573-6801

Phone 813-633-3600 · Fax 813-634-8210

Mailing address

10051 5th Street North Attn: Credentialing
Suite 200
St Petersburg, FL 33702

Phone 727-824-0780 · Fax 813-634-8210

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