MEDICARE: MRS. CYNTHIA JOSEPHINE DUFFY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	SW7390	FL

General Provider Information

NPI Number	:	1629301577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA JOSEPHINE DUFFY

Provider Business Mailing Address
First Line	:	17453 QUEENSLAND ST
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7862
Country	:	US
Telephone Number	:	813-298-8332
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 E PALM AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-3512
Country	:	US
Telephone Number	:	813-273-7090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	09/10/2009

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