Healthcare Provider Details

I. General information

NPI: 1215544069
Provider Name (Legal Business Name): MS. CHINIKQUA S SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4112 DIJON DR
ORLANDO FL
32808-2282
US

IV. Provider business mailing address

PO BOX 607966
ORLANDO FL
32860-7966
US

V. Phone/Fax

Practice location:
  • Phone: 407-840-9227
  • Fax: 407-559-8073
Mailing address:
  • Phone: 407-840-9227
  • Fax: 407-559-8073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: