Provider Demographics
NPI:1639286180
Name:BURT, CYNTHIA DEGUIA (BSMT- RMT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DEGUIA
Last Name:BURT
Suffix:
Gender:F
Credentials:BSMT- RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10500
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-3500
Mailing Address - Country:US
Mailing Address - Phone:340-774-2760
Mailing Address - Fax:340-774-2760
Practice Address - Street 1:10TH STREET ESTATE THOMAS
Practice Address - Street 2:
Practice Address - City:ST.THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00801
Practice Address - Country:US
Practice Address - Phone:340-774-2760
Practice Address - Fax:340-774-2760
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory