Provider Demographics
NPI:1548353204
Name:RAYBON, CINDIE L (MD)
Entity type:Individual
Prefix:DR
First Name:CINDIE
Middle Name:L
Last Name:RAYBON
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 1:109 SUNSET PT
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-9048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 ZEAGLER DR STE 7
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3826
Practice Address - Country:US
Practice Address - Phone:386-385-8137
Practice Address - Fax:386-487-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60390208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374809000Medicaid
FL374809000Medicaid
FL23857OtherBC/BS