Healthcare Provider Details

I. General information

NPI: 1366707606
Provider Name (Legal Business Name): CYNTHIA LOUISE WOLFORD ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 1ST ST N
WINTER HAVEN FL
33881-4113
US

IV. Provider business mailing address

320 1ST ST N
WINTER HAVEN FL
33881-4113
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-5505
  • Fax: 863-293-5374
Mailing address:
  • Phone: 863-294-5505
  • Fax: 239-785-1750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9175858
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: