MEDICARE: LINDSEY CULBRETH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9110509	FL

General Provider Information

NPI Number	:	1205354933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY CULBRETH PA-C

Provider Business Mailing Address
First Line	:	3261 HWY 27/441 STE B1
Second Line	:
City	:	FRUITLAND PARK
State	:	FL
Zip	:	34731-4492
Country	:	US
Telephone Number	:	352-460-4268
Fax Number	:

Provider Business Practice Location Address
First Line	:	3261 HWY 27/441 STE B1
Second Line	:
City	:	FRUITLAND PARK
State	:	FL
Zip	:	34731-4492
Country	:	US
Telephone Number	:	352-460-4268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2017
Last Update Date	:	09/01/2017

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Directions to “ LINDSEY CULBRETH PA-C” Practice Location

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