Provider Demographics
NPI:1649716408
Name:ST CERE, CYNDA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CYNDA
Middle Name:
Last Name:ST CERE
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:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-1431
Mailing Address - Country:US
Mailing Address - Phone:361-572-0333
Mailing Address - Fax:361-703-5101
Practice Address - Street 1:23040 PANAMA CITY BEACH PKWY
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413
Practice Address - Country:US
Practice Address - Phone:850-770-3230
Practice Address - Fax:850-770-3235
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9355683363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019999500Medicaid