Basic Information
| Provider Information | |||||||||
| NPI: | 1356895536 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNITED CEREBRAL PALSY OF CENTRAL FLORIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 W COLONIAL DR | ||||||||
| Address2: | 300 | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328047163 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 756 N SUN DR | ||||||||
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| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327462507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078523300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2016 | ||||||||
| LastUpdateDate: | 10/13/2021 | ||||||||
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| AuthorizedOfficialLastName: | CORBETT | ||||||||
| AuthorizedOfficialFirstName: | LEAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | SPEECH-LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8568895974 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.A. | ||||||||
| NPICertificationDate: | 10/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251V00000X | Y | Agencies | Voluntary or Charitable |
No ID Information.