Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME25417 | FL |
NPI | 1083611545 |
---|---|
Provider Name | Dr. Richard A Lynn |
First Address | West Palm Beach, FL 33401-3404 |
Second Address | West Palm Beach, FL 33401-3404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 01/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057506200 | (05) | FL |
D55823 | (02) |