MEDICARE: CYNTHIA WOOD WHITE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME82821	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023034949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA WOOD WHITE M.D.

Provider Business Mailing Address
First Line	:	720 BROOKER CREEK BLVD STE 215
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-2937
Country	:	US
Telephone Number	:	813-854-2003
Fax Number	:	813-436-5378

Provider Business Practice Location Address
First Line	:	4911 S MANHATTAN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-3429
Country	:	US
Telephone Number	:	813-755-4025
Fax Number	:	813-755-4026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	10/12/2023

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