Healthcare Provider Details

I. General information

NPI: 1629019377
Provider Name (Legal Business Name): CATHY CHIOVITTI WILLIAMS CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD RECREATION THERAPY 117
TAMPA FL
33612-4745
US

IV. Provider business mailing address

2714 MAJESTIC OAKS CT
PLANT CITY FL
33566-7571
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax: 813-903-4853
Mailing address:
  • Phone: 813-752-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number10441
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: