Provider Demographics
NPI:1558463513
Name:BILLIPS, CHERYL LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LYNNE
Last Name:BILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W STATE ROAD 436
Mailing Address - Street 2:SUITE 2209
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3054
Mailing Address - Country:US
Mailing Address - Phone:407-862-7699
Mailing Address - Fax:407-862-9672
Practice Address - Street 1:801 W STATE ROAD 436
Practice Address - Street 2:SUITE 2209
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3054
Practice Address - Country:US
Practice Address - Phone:407-862-7699
Practice Address - Fax:407-862-9672
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71919174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00122580OtherRAILROAD MEDICARE
FL44793OtherBLUE CROSS BLUE SHIELD
FL44793Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
FL44793OtherBLUE CROSS BLUE SHIELD