Healthcare Provider Details

I. General information

NPI: 1912747528
Provider Name (Legal Business Name): CYNTHIA THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA LABOY

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 COMMERCE CENTER DR
SAINT CLOUD FL
34769-1549
US

IV. Provider business mailing address

311 COMMERCE CENTER DR
SAINT CLOUD FL
34769-1549
US

V. Phone/Fax

Practice location:
  • Phone: 407-989-4040
  • Fax: 407-201-7195
Mailing address:
  • Phone: 407-419-7323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: