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General NPI Number Information
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NPI Number | 1467603837
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Entity Type | Individual
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Provider Name | CYNTHIA LYNNE STEWART PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 8877 SE 165TH MULBERRY LN
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City | THE VILLAGES
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State | FL
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Zip | 32162-5887
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Country | US
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Telephone | 352-674-1750
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Fax | 352-674-8950
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Provider Business Mailing Address
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Address Line | 1020 LAKE SUMTER LNDG
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City | THE VILLAGES
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State | FL
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Zip | 32162-2699
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Country | US
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Telephone | 352-674-8905
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Fax | 352-674-8919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 03994
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0003861
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107330
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License Number State | FL
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