Provider Demographics
NPI:1184780405
Name:HUGHES, CYNTHIA E
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 S PATRICK DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4475
Mailing Address - Country:US
Mailing Address - Phone:321-777-1316
Mailing Address - Fax:321-309-5002
Practice Address - Street 1:2181 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4475
Practice Address - Country:US
Practice Address - Phone:321-777-1316
Practice Address - Fax:321-309-5002
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1068064OtherCARE PLUS HEALTH PLAN
FL08419OtherBLUE CROSS & BLUE SHIELD
01237022OtherAMERIGROUP
FL08419OtherBLUE CROSS & BLUE SHIELD
FLE21821Medicare UPIN
FL08419Medicare ID - Type Unspecified