Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH0004163 | FL |
NPI | 1457380255 |
---|---|
Provider Name | Dr. Sheryl A Ballinger |
First Address | Wesley Chapel, FL 33543-7023 |
Second Address | Wesley Chapel, FL 33543-7023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-55673 | (02) | FL |