Provider Demographics
NPI:1922348309
Name:SURDOVEL, CYNDEL
Entity Type:Individual
Prefix:MRS
First Name:CYNDEL
Middle Name:
Last Name:SURDOVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNDEL
Other - Middle Name:
Other - Last Name:BARBAROSSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1078 COVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7039
Mailing Address - Country:US
Mailing Address - Phone:407-227-8935
Mailing Address - Fax:
Practice Address - Street 1:1809 E BROADWAY ST # 122
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8597
Practice Address - Country:US
Practice Address - Phone:407-359-5693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6252235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008945400Medicaid