Healthcare Provider Details

I. General information

NPI: 1265666986
Provider Name (Legal Business Name): CHERYL A YARCHUK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2009
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 N FLORIDA AVE UNIT 1 HERNANDO PLAZA
HERNANDO FL
34442-4390
US

IV. Provider business mailing address

2780 N FLORIDA AVE UNIT 1 HERNANDO PLAZA
HERNANDO FL
34442-4390
US

V. Phone/Fax

Practice location:
  • Phone: 877-773-7123
  • Fax: 877-773-7123
Mailing address:
  • Phone: 877-773-7123
  • Fax: 877-773-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number009619-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT18040
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: