Provider Demographics
NPI:1841485067
Name:FLEITAS, CYNTHIA LYNN (PA)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:FLEITAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:LYNN
Other - Last Name:SIKSNIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4308 ALTON ROAD
Mailing Address - Street 2:S. 510
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2840
Mailing Address - Country:US
Mailing Address - Phone:305-674-7414
Mailing Address - Fax:305-674-1459
Practice Address - Street 1:4308 ALTON ROAD
Practice Address - Street 2:S. 510
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-674-7414
Practice Address - Fax:305-674-1459
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9104315363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical