Provider Demographics
NPI:1407804479
Name:PLATT, CYNTHIA H (PA)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:H
Last Name:PLATT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SOUTH ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502
Mailing Address - Country:US
Mailing Address - Phone:850-431-5354
Mailing Address - Fax:
Practice Address - Street 1:5151 NORTH 9TH AVANUE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504
Practice Address - Country:US
Practice Address - Phone:850-416-6108
Practice Address - Fax:855-527-5510
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2195363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant