Provider Demographics
NPI:1851506760
Name:PARKER, CINDY RENEE (DHSC, PA-C)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:RENEE
Last Name:PARKER
Suffix:
Gender:F
Credentials:DHSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1794 ARASH CIR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7303
Mailing Address - Country:US
Mailing Address - Phone:386-316-2525
Mailing Address - Fax:903-213-9186
Practice Address - Street 1:951 N WASHINGTON AVE BLDG 4
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2194
Practice Address - Country:US
Practice Address - Phone:321-443-2247
Practice Address - Fax:321-635-9310
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA3248363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101534500Medicaid
FLPA3248OtherSTATE LICENSE
FLPA3248OtherSTATE LICENSE