MEDICARE: MARY LYNCH ARNP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ARNP1749142	FL

General Provider Information

NPI Number	:	1730178815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LYNCH ARNP

Provider Business Mailing Address
First Line	:	PO BOX 863407
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3407
Country	:	US
Telephone Number	:	941-917-4071
Fax Number	:	941-917-1875

Provider Business Practice Location Address
First Line	:	1219 S EAST AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-2340
Country	:	US
Telephone Number	:	941-953-2295
Fax Number	:	941-366-3815

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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