Healthcare Provider Details

I. General information

NPI: 1356342737
Provider Name (Legal Business Name): CYNTHIA CADSON CLAYTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205 VILLAGE BLVD
WEST PALM BEACH FL
33407-7907
US

IV. Provider business mailing address

5205 VILLAGE BLVD
WEST PALM BEACH FL
33407-7907
US

V. Phone/Fax

Practice location:
  • Phone: 561-242-0505
  • Fax: 561-242-9883
Mailing address:
  • Phone: 561-242-0505
  • Fax: 561-242-9883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME85514
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: