Healthcare Provider Details

I. General information

NPI: 1518287861
Provider Name (Legal Business Name): CHERYL LYNN WILLIAMS OTR/L, MED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date: 07/29/2019
Reactivation Date: 08/16/2019

III. Provider practice location address

3305 S. ORANGE AVE.
ORLANDO FL
32806
US

IV. Provider business mailing address

6520 THIRD STREET
ROCKLEDGE FL
32955
US

V. Phone/Fax

Practice location:
  • Phone: 407-277-5400
  • Fax: 321-281-4942
Mailing address:
  • Phone: 321-622-8792
  • Fax: 321-622-8793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT20157
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 10594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: