Provider Demographics
NPI:1821039462
Name:WIRTH, CYNTHIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:D
Last Name:WIRTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:D
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2657 NE 164TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4011
Mailing Address - Country:US
Mailing Address - Phone:305-944-2105
Mailing Address - Fax:305-944-2106
Practice Address - Street 1:3966 NW 167TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-6291
Practice Address - Country:US
Practice Address - Phone:305-430-9499
Practice Address - Fax:305-474-0899
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0059102207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine