Provider Demographics
NPI:1184831463
Name:MCGINNIS, CHERYL W (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:W
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP743042364ST0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364ST0500XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistTransplantation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305078500Medicaid
S93766Medicare UPIN
FL305078500Medicaid