Provider Demographics
NPI:1073058129
Name:GARCIA-TAMEZ, CYNTHIA ANN
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:GARCIA-TAMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W HILLSBORO BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1610
Mailing Address - Country:US
Mailing Address - Phone:954-246-1531
Mailing Address - Fax:954-843-7313
Practice Address - Street 1:19178 BLANCO RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3654
Practice Address - Country:US
Practice Address - Phone:210-402-6080
Practice Address - Fax:210-402-6081
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily