Provider Demographics
NPI:1912763244
Name:CHERY TELECARE
Entity Type:Organization
Organization Name:CHERY TELECARE
Other - Org Name:CHERY TELECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MS
Authorized Official - First Name:INA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTIN CHERY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:407-310-4416
Mailing Address - Street 1:6388 SILVER STAR RD STE 1E
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3235
Mailing Address - Country:US
Mailing Address - Phone:407-848-7108
Mailing Address - Fax:407-987-4164
Practice Address - Street 1:6388 SILVER STAR RD STE 1E
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3235
Practice Address - Country:US
Practice Address - Phone:407-848-7108
Practice Address - Fax:407-987-4164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care