Individual
AMY LYNN CUMMISKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
615 E PRINCETON ST, SUITE 540, ORLANDO, FL 32803-1456
(407) 236-0006
(407) 236-0007
Mailing address
615 E PRINCETON ST, SUITE 540, ORLANDO, FL 32803-1456
(407) 236-0006
(407) 236-0007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01022
TX
363AS0400X
Surgical Physician Assistant
PA01022
TX
363AS0400X
Surgical Physician Assistant
Primary
PA9106130
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004318800
—
FL
05
—
183945801
—
TX
01
—
200132820A
OKLAHOMA MEDICAID
OK
01
—
8Y0707
BCBS
TX
01
—
Y0A90
BCBS
FL
Enumeration date
07/07/2006
Last updated
01/11/2016
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