Provider Demographics
NPI:1265698377
Name:MACASPAC, CHERRYGAIL (PT)
Entity type:Individual
Prefix:
First Name:CHERRYGAIL
Middle Name:
Last Name:MACASPAC
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 1:10830 CYPRESS TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5024
Mailing Address - Country:US
Mailing Address - Phone:407-590-6895
Mailing Address - Fax:
Practice Address - Street 1:6005 SILVER STAR RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-8203
Practice Address - Country:US
Practice Address - Phone:407-299-5003
Practice Address - Fax:407-299-1471
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist