Provider Demographics
NPI:1215123286
Name:CINDY MARIKA D.O. PA
Entity type:Organization
Organization Name:CINDY MARIKA D.O. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:SHEILA
Authorized Official - Last Name:MARIKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-349-2094
Mailing Address - Street 1:1604 TOWN CENTER CIR
Mailing Address - Street 2:STE A
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3640
Mailing Address - Country:US
Mailing Address - Phone:954-349-2094
Mailing Address - Fax:954-349-2098
Practice Address - Street 1:1604 TOWN CENTER CIR
Practice Address - Street 2:STE A
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3640
Practice Address - Country:US
Practice Address - Phone:954-349-2094
Practice Address - Fax:954-349-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80071WMedicare PIN