Provider Demographics
NPI:1801896832
Name:GABALDON, CYNTHIA (DC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:GABALDON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 SPRING CTR BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-5000
Mailing Address - Country:US
Mailing Address - Phone:407-695-1900
Mailing Address - Fax:407-695-1908
Practice Address - Street 1:1175 SPRING CTR BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5000
Practice Address - Country:US
Practice Address - Phone:407-695-1900
Practice Address - Fax:407-695-1908
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381910800Medicaid
FL89918OtherBCBS
V04904Medicare UPIN
FL381910800Medicaid