Provider Demographics
NPI:1659051936
Name:CANCHAN, CINTHIA (APRN)
Entity Type:Individual
Prefix:
First Name:CINTHIA
Middle Name:
Last Name:CANCHAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 NE 14TH ST APT 1406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1616
Mailing Address - Country:US
Mailing Address - Phone:305-206-8734
Mailing Address - Fax:
Practice Address - Street 1:245 NE 14TH ST APT 1406
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1616
Practice Address - Country:US
Practice Address - Phone:305-206-8734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027428363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner