Provider Demographics
NPI:1356346894
Name:TIE, OEN-HIANG CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:OEN-HIANG
Middle Name:CYNTHIA
Last Name:TIE
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 1:1981 CAPITAL CIR NE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4421
Mailing Address - Country:US
Mailing Address - Phone:850-402-9444
Mailing Address - Fax:850-402-0188
Practice Address - Street 1:1981 CAPITAL CIR NE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4421
Practice Address - Country:US
Practice Address - Phone:850-402-9444
Practice Address - Fax:850-402-0188
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78591207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257072600Medicaid
FL46953XMedicare ID - Type Unspecified
FL257072600Medicaid