Healthcare Provider Details

I. General information

NPI: 1730007170
Provider Name (Legal Business Name): DANIEL LYNCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 W HANNA AVE
TAMPA FL
33604-6318
US

IV. Provider business mailing address

2002 W HANNA AVE
TAMPA FL
33604-6318
US

V. Phone/Fax

Practice location:
  • Phone: 813-426-5937
  • Fax:
Mailing address:
  • Phone: 813-426-5937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: