Individual
CINDY J PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
301 MEMORIAL MEDICAL PKWY, DAYTONA BEACH, FL 32117-5167
(386) 231-6000
Mailing address
PO BOX 945921, ATLANTA, GA 30394-5921
(386) 231-4529
(386) 672-9904
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0102201838
VA
207L00000X
Anesthesiology Physician
H0052675
MD
207L00000X
Anesthesiology Physician
Primary
OS20470
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033579
ANTHEM
VA
05
—
1629055447
—
VA
01
—
31116
AMERIGROUP
VA
01
—
484645
NCPPO
VA
01
—
K142-0001
CAREFIRST
VA
Enumeration date
12/22/2005
Last updated
03/22/2024
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