Provider Demographics
NPI:1700187051
Name:BRYAN, CYNTHIA M (LPTA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:BRYAN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 GOLDEN GATE POINT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-6654
Mailing Address - Country:US
Mailing Address - Phone:904-993-6788
Mailing Address - Fax:
Practice Address - Street 1:3221 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6452
Practice Address - Country:US
Practice Address - Phone:941-955-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20868225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant