Provider Demographics
NPI:1447204003
Name:SPATA, CINDY (PA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:SPATA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2964 N STATE ROAD 7
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5715
Mailing Address - Country:US
Mailing Address - Phone:954-975-3102
Mailing Address - Fax:954-973-1882
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 110
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-975-3102
Practice Address - Fax:954-973-1882
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA0003495363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant