Cynetra Zollicoffer

Individual provider Active NPI Phlebology Physician · Tampa, FL

NPI 1922589068 · NPPES record last updated Aug 27, 2018

Key facts

NPI
1922589068
Entity type
Individual (NPI type 1)
Primary specialty
Phlebology Physician 202K00000X
License
K6R7F3A3 (GA)
Practice address
10208 Douglas Oaks Cir Apt 104
Tampa, FL 33610-8651
Phone
(678) 499-5745
NPI assigned
Aug 27, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
K6R7F3A3GAMDPhlebology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A1 Diagnostics LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X K6R7F3A3 GA Yes

Addresses

Primary practice location

10208 Douglas Oaks Cir Apt 104
Tampa, FL 33610-8651

Mailing address

10208 Douglas Oaks Cir Apt 104
Tampa, FL 33610-8651
Phone (678) 499-5745

Other providers in Tampa, FL

All providers in Tampa, FL · Phlebology Physician in Florida

Sources for this page

Verify at the official NPI Registry.