Provider Demographics
NPI:1871573261
Name:MCDONALD, CYNTHIA C (DPM)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:C
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 NEWBERRY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2822
Mailing Address - Country:US
Mailing Address - Phone:352-331-3077
Mailing Address - Fax:352-331-3265
Practice Address - Street 1:4343 W NEWBERRY RD STE 1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2822
Practice Address - Country:US
Practice Address - Phone:352-331-3077
Practice Address - Fax:352-331-3265
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2406213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390180700Medicaid
FLU48309Medicare UPIN
FL390180700Medicaid