Provider Demographics
NPI:1629171798
Name:DAY, CHERYL CHRIS (PA)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:CHRIS
Last Name:DAY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 LAKE UNDERHILL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5090
Mailing Address - Country:US
Mailing Address - Phone:407-380-0201
Mailing Address - Fax:407-380-0301
Practice Address - Street 1:11325 LAKE UNDERHILL RD STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5090
Practice Address - Country:US
Practice Address - Phone:407-380-0201
Practice Address - Fax:407-380-0301
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0002571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24039OtherMEDICARE GROUP
FL290864600Medicaid
FLYO9UJOtherBLUE CROSS BLUE SHIELD
FL259038700OtherMEDICAID GROUP
S74536Medicare UPIN
FL259038700OtherMEDICAID GROUP