Provider Demographics
NPI:1588825442
Name:DOUGHAN, CHERIE (PT)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:
Last Name:DOUGHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 AMBERJACK TER
Mailing Address - Street 2:
Mailing Address - City:PLACIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33946-2300
Mailing Address - Country:US
Mailing Address - Phone:941-697-4213
Mailing Address - Fax:941-697-4213
Practice Address - Street 1:10 AMBERJACK TER
Practice Address - Street 2:
Practice Address - City:PLACIDA
Practice Address - State:FL
Practice Address - Zip Code:33946-2300
Practice Address - Country:US
Practice Address - Phone:941-697-4213
Practice Address - Fax:941-697-4213
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 6043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist