Provider Demographics
NPI:1942394978
Name:WORRELL-WHITE, CYNTHIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:L
Last Name:WORRELL-WHITE
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 1:7051 HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:MC DAVID
Mailing Address - State:FL
Mailing Address - Zip Code:32568-2035
Mailing Address - Country:US
Mailing Address - Phone:850-572-4156
Mailing Address - Fax:
Practice Address - Street 1:7051 HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:MC DAVID
Practice Address - State:FL
Practice Address - Zip Code:32568-2035
Practice Address - Country:US
Practice Address - Phone:850-572-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME22026208000000X
ARC-4429208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics