Healthcare Provider Details

I. General information

NPI: 1831122019
Provider Name (Legal Business Name): UNITED CEREBRAL PALSY OF CENTRAL FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4780 DATA CT
ORLANDO FL
32817-8331
US

IV. Provider business mailing address

4780 DATA CT
ORLANDO FL
32817-8331
US

V. Phone/Fax

Practice location:
  • Phone: 407-904-0133
  • Fax:
Mailing address:
  • Phone: 407-852-3328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberBUS0022327-001
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ILENE WILKINS
Title or Position: CEO PRESIDENT
Credential:
Phone: 407-852-3303