Provider Demographics
NPI:1801900626
Name:KARSONOVICH, CYNTHIA MENDEZ (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MENDEZ
Last Name:KARSONOVICH
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:JAMES A HALEY VA HOSPITAL
Mailing Address - Street 2:13000 BRUCE B DOWNS BLVD (112)
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:813-903-4832
Mailing Address - Fax:813-978-5936
Practice Address - Street 1:JAMES A HALEY VA HOSPITAL
Practice Address - Street 2:13000 BRUCE B DOWNS BLVD (112)
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-903-4832
Practice Address - Fax:813-978-5936
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032178208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery