Provider Demographics
NPI:1215524178
Name:BURRIS, CYNTHIA LYNN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:BURRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 URANUS TER
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1661
Mailing Address - Country:US
Mailing Address - Phone:561-294-6777
Mailing Address - Fax:
Practice Address - Street 1:922 FORESTERIA DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3106
Practice Address - Country:US
Practice Address - Phone:561-840-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty