Healthcare Provider Details

I. General information

NPI: 1225907215
Provider Name (Legal Business Name): LYNDIE BENTLEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 N DONNELLY ST
MOUNT DORA FL
32757-2820
US

IV. Provider business mailing address

PO BOX 100237
GAINESVILLE FL
32610-0237
US

V. Phone/Fax

Practice location:
  • Phone: 352-720-3149
  • Fax:
Mailing address:
  • Phone: 352-392-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11043367
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: