Healthcare Provider Details

I. General information

NPI: 1306603824
Provider Name (Legal Business Name): CINTHIA JAQUELINE DUARTE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E ROLLINS ST STE 4700
ORLANDO FL
32804-5534
US

IV. Provider business mailing address

265 E ROLLINS ST STE 4700
ORLANDO FL
32804-5534
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3655
  • Fax: 407-821-3656
Mailing address:
  • Phone: 407-821-3655
  • Fax: 407-821-3656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberPA9118268
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9118268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: