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NPI Code Detail

MEDICARE: DR. LYNN MARY COLUCCI DC

MEDICARE: DR. LYNN MARY COLUCCI DC
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
1111N00000XChiropractorCH5131FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1629889OTHERFLACN/UHC
270781OTHERFLBCBS FL PROVIDER NUMBER

General Provider Information

NPI Number : 1336191329
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNN MARY COLUCCI DC
Provider Business Mailing Address
First Line : 516 PATRICIA AVE
Second Line :
City : DUNEDIN
State : FL
Zip : 34698-7813
Country : US
Telephone Number : 727-736-7000
Fax Number : 706-736-3556
Provider Business Practice Location Address
First Line : 516 PATRICIA AVE
Second Line :
City : DUNEDIN
State : FL
Zip : 34698-7813
Country : US
Telephone Number : 727-736-7000
Fax Number : 706-736-3556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/09/2007

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