Provider Demographics
NPI:1366718637
Name:SUMMERS, CINDY (LPTA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAITLAND AVE
Mailing Address - Street 2:#200
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5572
Mailing Address - Country:US
Mailing Address - Phone:407-260-1297
Mailing Address - Fax:
Practice Address - Street 1:2500 W LAKE MARY BLVD
Practice Address - Street 2:SUITE # 208
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-323-6955
Practice Address - Fax:407-323-4564
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 21716174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist