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General NPI Number Information
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NPI Number | 1043708217
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Entity Type | Organization
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Legal Business Name | CINDIE RAYBON, MD, LLC
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 700 ZEAGLER DR STE 7
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City | PALATKA
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State | FL
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Zip | 32177-3826
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Country | US
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Telephone | 386-385-8137
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Fax | 386-487-2113
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Provider Business Mailing Address
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Address Line | 109 SUNSET PT
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City | PALATKA
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State | FL
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Zip | 32177-9048
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Country | US
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Telephone | 352-212-1767
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Fax | 386-487-2113
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Authorized Official
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Title or Position | OWNER
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Name | CINDIE RAYBON
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Credential | MD
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Telephone | 352-212-1796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME60390
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License Number State | FL
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