Provider Demographics
NPI:1023409588
Name:JEAN, CYNTHIA L (PHARMD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:JEAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1839
Mailing Address - Country:US
Mailing Address - Phone:954-519-2900
Mailing Address - Fax:800-419-2801
Practice Address - Street 1:6910 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-1839
Practice Address - Country:US
Practice Address - Phone:954-519-2900
Practice Address - Fax:800-418-2801
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist