Healthcare Provider Details

I. General information

NPI: 1780867622
Provider Name (Legal Business Name): KELLY ELIZABETH LYNCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 N FEDERAL HIGHWAY AMERICAN ANESTHESIOLOGY SERVICES OF FLORIDA, INC.
FORT LAUDERDALE FL
33308-4603
US

IV. Provider business mailing address

PO BOX 551420
FORT LAUDERDALE FL
33355-1420
US

V. Phone/Fax

Practice location:
  • Phone: 954-493-5005
  • Fax: 954-938-0957
Mailing address:
  • Phone: 800-243-3839
  • Fax: 855-851-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberN1748
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME115801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: