Provider Demographics
NPI:1194849869
Name:JENKINS, CYNTHIA H (MACCC,SLP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:H
Last Name:JENKINS
Suffix:
Gender:F
Credentials:MACCC,SLP
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:HARDY
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA-CCC-SLP
Mailing Address - Street 1:PO BOX 951137
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-1137
Mailing Address - Country:US
Mailing Address - Phone:407-260-0020
Mailing Address - Fax:407-260-9555
Practice Address - Street 1:1704 N RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3409
Practice Address - Country:US
Practice Address - Phone:407-260-0020
Practice Address - Fax:407-260-9555
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA00002180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886089100Medicaid
FL881991200Medicaid