Healthcare Provider Details

I. General information

NPI: 1346316601
Provider Name (Legal Business Name): LYNN MERRITT BERRINGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 MAITLAND SUMMIT BLVD
ORLANDO FL
32810-5915
US

IV. Provider business mailing address

8701 MAITLAND SUMMIT BLVD
ORLANDO FL
32810-5915
US

V. Phone/Fax

Practice location:
  • Phone: 407-916-4522
  • Fax: 407-916-4525
Mailing address:
  • Phone: 407-916-4522
  • Fax: 407-916-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME36554
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: