Provider Demographics
NPI:1205350261
Name:BORDERS, CYNTHIA FLORES (RDN, LDN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:FLORES
Last Name:BORDERS
Suffix:
Gender:F
Credentials:RDN, LDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7450
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-1450
Mailing Address - Country:US
Mailing Address - Phone:979-777-1158
Mailing Address - Fax:
Practice Address - Street 1:419 5TH ST
Practice Address - Street 2:
Practice Address - City:SUNSET BEACH
Practice Address - State:NC
Practice Address - Zip Code:28468-4009
Practice Address - Country:US
Practice Address - Phone:979-777-1158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
NCL005252133V00000X
NV39539-DIE-0133V00000X
SC1949133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN