MEDICARE: CYNTHIA DENISE HUMENIC NP

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	363L00000X	Nurse Practitioner	RN206611	GA
2	363L00000X	Nurse Practitioner	APRN11009070	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN206611	OTHER	GA	STATE OF GA NURSE PRACTICIONER LICENSE # RN206611

General Provider Information

NPI Number	:	1881181584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA DENISE HUMENIC NP

Provider Business Mailing Address
First Line	:	601 S HARBOUR ISLAND BLVD STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5925
Country	:	US
Telephone Number	:	727-322-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W 19TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4659
Country	:	US
Telephone Number	:	850-344-1433
Fax Number	:

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

Provider Enumeration Date	:	04/18/2018
Last Update Date	:	02/11/2026

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