Provider Demographics
NPI:1992423412
Name:FERDINAND, CINDY MICHELLE (OTA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:MICHELLE
Last Name:FERDINAND
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9037 INDIGO BREEZE CT
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-5304
Mailing Address - Country:US
Mailing Address - Phone:813-816-6158
Mailing Address - Fax:
Practice Address - Street 1:4411 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7211
Practice Address - Country:US
Practice Address - Phone:813-872-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18341224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18341Medicaid