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General NPI Number Information
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NPI Number | 1497957708
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Entity Type | Individual
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Provider Name | CYNTHIA ANNE MACKEY OT
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 5860 GOLDEN GATE PKWY
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City | NAPLES
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State | FL
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Zip | 34116-7459
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Country | US
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Telephone | 239-455-9525
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Fax | 239-455-2844
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Provider Business Mailing Address
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Address Line | 15130 SUMMIT PLACE CIR
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City | NAPLES
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State | FL
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Zip | 34119-4107
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Country | US
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Telephone | 239-248-7873
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Fax | 239-348-7887
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | OT 11025
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License Number State | FL
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