Healthcare Provider Details

I. General information

NPI: 1578471249
Provider Name (Legal Business Name): LYNN MEDICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN RICKER

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 W ROBERTSON ST STE 108
BRANDON FL
33511-4900
US

IV. Provider business mailing address

721 W ROBERTSON ST STE 108
BRANDON FL
33511-4900
US

V. Phone/Fax

Practice location:
  • Phone: 813-684-4221
  • Fax:
Mailing address:
  • Phone: 813-684-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: