Provider Demographics
NPI:1942270988
Name:HALCIN, CYNTHIA H (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:H
Last Name:HALCIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 EXECUTIVE LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3595
Mailing Address - Country:US
Mailing Address - Phone:321-394-8000
Mailing Address - Fax:321-394-8002
Practice Address - Street 1:830 EXECUTIVE LN
Practice Address - Street 2:SUITE 110
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3595
Practice Address - Country:US
Practice Address - Phone:321-394-8000
Practice Address - Fax:321-394-8002
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73166207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL070016986OtherRAILROAD MEDICARE
FL41264OtherBLUE CROSS BLUE SHIELD
FL2965384OtherCIGNA
FL001732027OtherUNITED HEALTH CARE
FL2965384OtherCIGNA
FLG53682Medicare UPIN