MEDICARE: MS. CHERYL A. MALONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 753	FL

General Provider Information

NPI Number	:	1275758922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHERYL A. MALONE

Provider Business Mailing Address
First Line	:	1417 N SEMORAN BLVD
Second Line	:	SUITE 216
City	:	ORLANDO
State	:	FL
Zip	:	32807-3555
Country	:	US
Telephone Number	:	407-282-0280
Fax Number	:	407-282-0552

Provider Business Practice Location Address
First Line	:	1417 N SEMORAN BLVD
Second Line	:	SUITE 216
City	:	ORLANDO
State	:	FL
Zip	:	32807-3555
Country	:	US
Telephone Number	:	407-282-0280
Fax Number	:	407-282-0552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	02/12/2019

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