Provider Demographics
NPI:1174724819
Name:ANDERSON, CYNTHIA SINHA (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SINHA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746654
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6654
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:1301 PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8432
Practice Address - Country:US
Practice Address - Phone:904-202-7300
Practice Address - Fax:904-202-7433
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME985512085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01349197OtherRR MEDICARE
GA171491454AMedicaid
FL278718100Medicaid
FLAG094FMedicare PIN
FLAG094RMedicare PIN
FLAG094DMedicare PIN
GA171491454AMedicaid
FLAG094EMedicare PIN
FLHV177ZMedicare PIN
FL278718100Medicaid
FLAG094ZMedicare PIN
FLAG094BMedicare PIN
FLAG094GMedicare PIN
FLAG094RMedicare PIN