Healthcare Provider Details

I. General information

NPI: 1194092114
Provider Name (Legal Business Name): MICHAEL FRANCIS LYNCH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2011
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

873 HULL RD
ORMOND BEACH FL
32174-0737
US

IV. Provider business mailing address

62 SANDCASTLE DR
ORMOND BEACH FL
32176-4157
US

V. Phone/Fax

Practice location:
  • Phone: 386-267-2965
  • Fax: 386-603-6007
Mailing address:
  • Phone: 570-762-3953
  • Fax: 386-603-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT33499
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: