=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851506760
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CINDY RENEE PARKER DHSC, PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2007
-----------------------------------------------------
Last Update Date | 03/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 MEMORIAL MEDICAL PKWY STE 301
-----------------------------------------------------
City | DAYTONA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32117-5157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-231-4450
-----------------------------------------------------
Fax | 386-231-4459
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 770 W GRANADA BLVD STE 101
-----------------------------------------------------
City | ORMOND BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32174-5179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-231-4519
-----------------------------------------------------
Fax | 386-368-8927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | PA3248
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------