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Individual

CHERRYLL A. LEBLANC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1613 HARRISON PKWY, #200, SUNRISE, FL 33323-2853
(954) 838-2371
(954) 851-1758
Mailing address
4655 CHADWICK DRIVE, BEAUMONT, TX 77706
(409) 347-4400

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
013378
LA
207P00000X
Emergency Medicine Physician
Primary
K6085
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113380304
TX
05
164362903
TX
05
168991101
TX
05
168991102
TX
05
168991104
TX
Enumeration date
06/05/2006
Last updated
05/07/2008
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