Provider Demographics
NPI:1285356782
Name:FOX, CINDY PAJARO (PA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:PAJARO
Last Name:FOX
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:PAJARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1336 SUGARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1477
Mailing Address - Country:US
Mailing Address - Phone:321-591-5543
Mailing Address - Fax:
Practice Address - Street 1:1336 SUGARWOOD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-1477
Practice Address - Country:US
Practice Address - Phone:321-591-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116166363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical