Healthcare Provider Details

I. General information

NPI: 1730178815
Provider Name (Legal Business Name): MARY LYNCH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 S EAST AVE
SARASOTA FL
34239-2340
US

IV. Provider business mailing address

PO BOX 863407
ORLANDO FL
32886-3407
US

V. Phone/Fax

Practice location:
  • Phone: 941-953-2295
  • Fax: 941-366-3815
Mailing address:
  • Phone: 941-917-4071
  • Fax: 941-917-1875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP1749142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: