Healthcare Provider Details

I. General information

NPI: 1487176137
Provider Name (Legal Business Name): CHERYL NICOLE HUGHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W OLD US HIGHWAY 441
MOUNT DORA FL
32757-3536
US

IV. Provider business mailing address

2799 W OLD US HIGHWAY 441
MOUNT DORA FL
32757-3536
US

V. Phone/Fax

Practice location:
  • Phone: 407-717-6360
  • Fax: 352-600-3091
Mailing address:
  • Phone: 407-717-6360
  • Fax: 352-600-3091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: