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NPI Code Detail

MEDICARE: MRS. CYNTHIA SUZANNE BRUNS-SMIT ARNP

MEDICARE: MRS. CYNTHIA SUZANNE BRUNS-SMIT ARNP
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
1363LF0000XFamily Nurse Practitioner1508412FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689880130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA SUZANNE BRUNS-SMIT ARNP
Provider Business Mailing Address
First Line : 7224 LAKE ENDERLY DR
Second Line :
City : BARTOW
State : FL
Zip : 33830-9008
Country : US
Telephone Number : 863-557-4858
Fax Number :
Provider Business Practice Location Address
First Line : 7575 OSCEOLA POLK LINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33896-9112
Country : US
Telephone Number : 321-677-0531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 05/06/2017

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