Provider Demographics
NPI:1043244148
Name:BRYANT, CYNTHIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:J
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-268-4200
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:490 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2871
Practice Address - Country:US
Practice Address - Phone:321-268-4200
Practice Address - Fax:321-268-1386
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1032232085R0001X
GA0531072085R0001X
SC286912085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBI255YOtherMEDICARE
FL000622200Medicaid