Healthcare Provider Details

I. General information

NPI: 1386790913
Provider Name (Legal Business Name): UNITED CEREBRAL PALSY OF CENTRAL FLORIDA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 S ORANGE AVE
ORLANDO FL
32806-6125
US

IV. Provider business mailing address

3305 S ORANGE AVE
ORLANDO FL
32806-6125
US

V. Phone/Fax

Practice location:
  • Phone: 407-852-3310
  • Fax: 407-852-3301
Mailing address:
  • Phone: 407-852-3310
  • Fax: 407-852-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberBUS00222327-001
License Number StateFL

VIII. Authorized Official

Name: MRS. LINA CARDONA
Title or Position: H.R ASSISTANT
Credential:
Phone: 407-852-3310