Provider Demographics
NPI:1609994417
Name:ATHERLEY-TODD, CHERYL GWYNETH (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:GWYNETH
Last Name:ATHERLEY-TODD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:GWYNETH
Other - Last Name:ATHERLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:16552 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1762
Mailing Address - Country:US
Mailing Address - Phone:954-249-6252
Mailing Address - Fax:
Practice Address - Street 1:16552 NW 22ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1762
Practice Address - Country:US
Practice Address - Phone:954-249-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC57-0359174OtherTAX ID