MEDICARE: EBONY LYNELL LINDO ITDS

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	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770250441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY LYNELL LINDO ITDS

Provider Business Mailing Address
First Line	:	547 TRYMORE DR SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-2373
Country	:	US
Telephone Number	:	929-271-4795
Fax Number	:

Provider Business Practice Location Address
First Line	:	547 TRYMORE DR SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-2373
Country	:	US
Telephone Number	:	929-271-4795
Fax Number	:

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

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	08/30/2021

Similar Medicare Providers

1215675814 — JEANTY'SCARE TRANSPORTATION LLC
Practice Location Address:

535 TRYMORE DR SE
PALM BAY, FL
32909-2373

Practice Phone: 347-773-8371
Practice Fax:

1487654166 — DR. DEAN L. SORRENTO DPM
Practice Location Address:

33920 US HIGHWAY 19 N STE 200
PALM HARBOR, FL
34684-2373

Practice Phone: 727-683-8012
Practice Fax: 407-671-4155

1942030127 — TIFFANIE MARQUICA ALHASSAN CNA
Practice Location Address:

449 PALM AVE
AKRON, OH
44301-2373

Practice Phone: 330-809-7567
Practice Fax:

1821968876 — ISMARI RIVERO ESTEVEZ
Practice Location Address:

2373 RUE RD
WEST PALM BEACH, FL
33415-7120

Practice Phone: 561-400-9153
Practice Fax:

1598617029 — PATRICIA PEREZ HERNANDEZ
Practice Location Address:

1667 TILLY ST SE
PALM BAY, FL
32909-5704

Practice Phone: 813-518-1782
Practice Fax:

1235784687 — MICHELLE SWANN APRN
Practice Location Address:

1810 ELDRON BLVD SE
PALM BAY, FL
32909-6831

Practice Phone: 321-434-3430
Practice Fax: 321-434-3432

Directions to “ EBONY LYNELL LINDO ITDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.