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NPI Code Detail

MEDICARE: ANNETTE M FRECHETTE-LYNN PA

MEDICARE: ANNETTE M FRECHETTE-LYNN PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9111545FL
2363A00000XPhysician AssistantPA9111545FL
3363AM0700XMedical Physician AssistantPA9111545FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023591674
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE M FRECHETTE-LYNN PA
Provider Business Mailing Address
First Line : 13020 N TELECOM PKWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-0925
Country : US
Telephone Number : 813-978-9700
Fax Number : 813-558-6186
Provider Business Practice Location Address
First Line : 3345 S DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33629-7817
Country : US
Telephone Number : 813-234-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 02/17/2021

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