Provider Demographics
NPI:1003554536
Name:CHOQUETTE, CYNTHIA G (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:G
Last Name:CHOQUETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16311 SE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:WEIRSDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32195-2303
Mailing Address - Country:US
Mailing Address - Phone:352-454-2366
Mailing Address - Fax:
Practice Address - Street 1:16311 SE 117TH AVE
Practice Address - Street 2:
Practice Address - City:WEIRSDALE
Practice Address - State:FL
Practice Address - Zip Code:32195-2303
Practice Address - Country:US
Practice Address - Phone:352-454-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9371029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9371029OtherRN LICENSE