Provider Demographics
NPI:1992785893
Name:LARIMER, CYNTHIA LYNN (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LYNN
Last Name:LARIMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CINDI
Other - Middle Name:LYNN
Other - Last Name:LARIMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:210 SW 86TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-1461
Mailing Address - Country:US
Mailing Address - Phone:352-331-3793
Mailing Address - Fax:352-331-3793
Practice Address - Street 1:6830 NW 11TH PL
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4254
Practice Address - Country:US
Practice Address - Phone:352-672-9000
Practice Address - Fax:352-505-8552
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0054910207Q00000X
FLME0054919207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0054910OtherFLORIDA LICENSE NUMBER
FL09819OtherBCBS
FL062219200Medicaid
FL062219200Medicaid
FLP88478Medicare UPIN
FL09819FMedicare ID - Type UnspecifiedMEDICARE