Healthcare Provider Details

I. General information

NPI: 1417958430
Provider Name (Legal Business Name): LYNDA APPLE BIDEAU M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 BURNS RD SUITE 100
PALM BEACH GARDENS FL
33410-4326
US

IV. Provider business mailing address

3365 BURNS RD STE 100
PALM BEACH GARDENS FL
33410-4302
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-4000
  • Fax: 561-493-8172
Mailing address:
  • Phone: 561-626-4000
  • Fax: 561-493-8172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 47906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: