Basic Information
| Provider Information | |||||||||
| NPI: | 1407804479 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PLATT | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 SOUTH ADAMS STREET | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504315354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5151 NORTH 9TH AVANUE | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504166108 | ||||||||
| FaxNumber: | 8555275510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA2195 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.