Provider Demographics
NPI:1962494369
Name:EATON, CYNTHIA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:EATON
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 1:8064 LAUREATE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827
Mailing Address - Country:US
Mailing Address - Phone:941-920-1376
Mailing Address - Fax:
Practice Address - Street 1:8064 LAUREATE BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827
Practice Address - Country:US
Practice Address - Phone:941-920-1376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49318OtherBCBS
FL263539900Medicaid
FLP00011808OtherMEDICARE RR
FL49318YMedicare PIN
FL263539900Medicaid