Provider Demographics
NPI:1134424716
Name:OTERO, CYNTHIA EDID (ARNP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:EDID
Last Name:OTERO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4723
Mailing Address - Country:US
Mailing Address - Phone:407-647-5996
Mailing Address - Fax:321-397-0259
Practice Address - Street 1:301 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4723
Practice Address - Country:US
Practice Address - Phone:407-647-5996
Practice Address - Fax:321-397-0259
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9205985363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health