Provider Demographics
NPI:1578736005
Name:WARD, CYNTHIA (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3859 SPIRITED CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-8240
Mailing Address - Country:US
Mailing Address - Phone:407-957-3335
Mailing Address - Fax:407-957-3335
Practice Address - Street 1:10743 NARCOOSSEE RD
Practice Address - Street 2:A 25
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6944
Practice Address - Country:US
Practice Address - Phone:407-658-9990
Practice Address - Fax:407-658-8880
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCQ803ZMedicare PIN