Provider Demographics
NPI:1821383894
Name:VIBAR, CYNTHIA N
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:N
Last Name:VIBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:N
Other - Last Name:VIBAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:1007 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-3515
Mailing Address - Country:US
Mailing Address - Phone:954-425-2371
Mailing Address - Fax:
Practice Address - Street 1:4340 MORSAY DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4877
Practice Address - Country:US
Practice Address - Phone:815-397-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018075225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist