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General NPI Number Information
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NPI Number | 1194204743
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Entity Type | Individual
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Provider Name | CHRISLINE MILARD
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 2653 ALCLOBE CIR
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City | OCOEE
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State | FL
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Zip | 34761
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Country | US
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Telephone | 407-574-4954
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Fax |
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Provider Business Mailing Address
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Address Line | 2653 ALCLOBE CIR
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City | OCOEE
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State | FL
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Zip | 34761-8972
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Country | US
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Telephone | 407-879-3996
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Fax | 407-574-4954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 6906790
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License Number State | FL
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