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General NPI Number Information
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NPI Number | 1871666214
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Entity Type | Individual
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Provider Name | JOAN YVONNE LYN D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 17 NW 168TH ST
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33169-6027
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Country | US
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Telephone | 786-955-6089
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Fax | 786-955-6091
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Provider Business Mailing Address
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Address Line | 6488 SW 25TH ST
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City | MIRAMAR
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State | FL
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Zip | 33023-2800
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Country | US
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Telephone | 954-625-5061
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Fax | 786-955-6091
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | OS9954
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 9954
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License Number State | FL
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