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General NPI Number Information
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NPI Number | 1780482406
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Entity Type | Organization
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Legal Business Name | ANDREA LYNN APRN
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 10150 HIGHLAND MANOR DR STE 200
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City | TAMPA
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State | FL
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Zip | 33610-9712
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Country | US
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Telephone | 850-510-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 3021 MOJAVE OAK DR
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City | VALRICO
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State | FL
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Zip | 33594-6795
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Country | US
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Telephone | 850-510-0060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA J LYNN
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Credential | APRN
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Telephone | 850-510-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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