Provider Demographics
NPI:1407895212
Name:POST-BONVINO, CYNTHIA (PA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:POST-BONVINO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:11903 SOUTHERN BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7644
Mailing Address - Country:US
Mailing Address - Phone:561-793-1475
Mailing Address - Fax:561-793-1478
Practice Address - Street 1:11903 SOUTHERN BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7644
Practice Address - Country:US
Practice Address - Phone:561-793-1475
Practice Address - Fax:561-793-1478
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006524363AM0700X
FL9105388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical