Provider Demographics
NPI:1720318090
Name:ROBINSON, CHERYL LYNETTE (PTA)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 24TH ST NW APT 1038
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-2294
Mailing Address - Country:US
Mailing Address - Phone:386-288-2732
Mailing Address - Fax:
Practice Address - Street 1:360 24TH ST NW APT 1038
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-2294
Practice Address - Country:US
Practice Address - Phone:386-288-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21915225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant