Provider Demographics
NPI:1306278494
Name:WILLIAMS, CHERRYL (AP)
Entity type:Individual
Prefix:
First Name:CHERRYL
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 SE HILLMOOR DR STE B-109
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7550
Mailing Address - Country:US
Mailing Address - Phone:772-940-7239
Mailing Address - Fax:772-337-0796
Practice Address - Street 1:1801 SE HILLMOOR DR
Practice Address - Street 2:SUITE 109-B
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7553
Practice Address - Country:US
Practice Address - Phone:772-337-9473
Practice Address - Fax:772-337-0796
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3177171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist