1144994708 NPI number — CINDY THI MILLSTEIN FNP-BC

Table of content: CINDY THI MILLSTEIN FNP-BC (NPI 1144994708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144994708 NPI number — CINDY THI MILLSTEIN FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLSTEIN
Provider First Name:
CINDY
Provider Middle Name:
THI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144994708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22723 ROYAL CROWN TER E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33433-6293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5301 S CONGRESS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTIS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33462-1149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-965-7300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  APRN11014235 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 115042000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".