=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457531386
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. CARMEN LYNCH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2007
-----------------------------------------------------
Last Update Date | 11/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5362 CENTRAL FLORIDA PKWY
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32821-8772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-239-1132
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5362 CENTRAL FLORIDA PKWY
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32821-8772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. CARMEN LYNCH
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 407-239-1132
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH6541
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------