Provider Demographics
NPI:1144723958
Name:CHERY, STEVENSON BRISSON (MD)
Entity type:Individual
Prefix:DR
First Name:STEVENSON
Middle Name:BRISSON
Last Name:CHERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 HOLLYWOOD BLVD # 5012
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6557
Mailing Address - Country:US
Mailing Address - Phone:954-967-0028
Mailing Address - Fax:
Practice Address - Street 1:5800 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5244
Practice Address - Country:US
Practice Address - Phone:954-966-3939
Practice Address - Fax:954-966-5959
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME143611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program