Healthcare Provider Details

I. General information

NPI: 1275577991
Provider Name (Legal Business Name): LYNNETTE MARIE LAMENDOLA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNETTE MARIE GIRJASHANKER ARNP

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAY PINES VA MEDICAL CENTER 10000 BAY PINES BLVD.
BAY PINES FL
33744
US

IV. Provider business mailing address

500 TRINITY LN N 11105
SAINT PETERSBURG FL
33716-1215
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax:
Mailing address:
  • Phone: 321-917-8643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3126672
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: