Provider Demographics
NPI:1083930150
Name:PAULIKAS, CYNTHIA A (APRN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:PAULIKAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1211
Mailing Address - Country:US
Mailing Address - Phone:407-425-1566
Mailing Address - Fax:407-422-0166
Practice Address - Street 1:217 HILLCREST ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1211
Practice Address - Country:US
Practice Address - Phone:407-425-1566
Practice Address - Fax:407-422-0166
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2782792363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002057700Medicaid
FL01361999OtherAMERIGROUP
P00891401OtherRAILROAD MEDICARE
FL561554OtherWELLCARE/STAYWELL
FL002057700Medicaid