Provider Demographics
NPI:1841455359
Name:COLLINS, CYNTHIA SUSAN (PHD, RD, LD/N)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUSAN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHD, RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11380 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE 209A
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3474
Mailing Address - Country:US
Mailing Address - Phone:561-691-3833
Mailing Address - Fax:561-694-6120
Practice Address - Street 1:11380 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE 209A
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3474
Practice Address - Country:US
Practice Address - Phone:561-691-3833
Practice Address - Fax:561-694-6120
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4496133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered