Provider Demographics
NPI:1033169909
Name:WILLIAMS, CYNTHIA MINTER (ARNP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MINTER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:M
Other - Last Name:CORBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:HOSFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32334-0175
Mailing Address - Country:US
Mailing Address - Phone:850-379-5800
Mailing Address - Fax:850-379-5811
Practice Address - Street 1:17316 NE STATE ROAD 65
Practice Address - Street 2:
Practice Address - City:HOSFORD
Practice Address - State:FL
Practice Address - Zip Code:32334-2415
Practice Address - Country:US
Practice Address - Phone:850-379-5800
Practice Address - Fax:850-379-5811
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1253662363L00000X
FLARNP1253662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302450400Medicaid
FL302450400Medicaid
FLY4897YMedicare ID - Type UnspecifiedMCR PROV NO