Healthcare Provider Details

I. General information

NPI: 1487980355
Provider Name (Legal Business Name): CHERYL CAWTHON AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5771 ROOSEVELT BLVD SUITE 300
CLEARWATER FL
33760-3407
US

IV. Provider business mailing address

5771 ROOSEVELT BLVD SUITE 300
CLEARWATER FL
33760-3407
US

V. Phone/Fax

Practice location:
  • Phone: 727-524-0900
  • Fax: 727-507-8822
Mailing address:
  • Phone: 727-524-0900
  • Fax: 727-507-8822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number941
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: