Provider Demographics
NPI:1396824637
Name:YAG HOWARD, CYNTHIA JILL (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JILL
Last Name:YAG HOWARD
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 1:1000 GOODLETTE RD N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5474
Mailing Address - Country:US
Mailing Address - Phone:239-649-8384
Mailing Address - Fax:239-643-0094
Practice Address - Street 1:1000 GOODLETTE RD N
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5474
Practice Address - Country:US
Practice Address - Phone:239-649-8384
Practice Address - Fax:239-643-0094
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71468207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
32568ZMedicare ID - Type Unspecified
G61116Medicare UPIN