MEDICARE: DR. LYNN A. VENTOLA PHD, MSN, ARNP

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
1	363LF0000X	Family Nurse Practitioner	9186293	FL

General Provider Information

NPI Number	:	1114358165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN A. VENTOLA PHD, MSN, ARNP

Provider Business Mailing Address
First Line	:	6151 LAKE OSPREY DR
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8419
Country	:	US
Telephone Number	:	941-907-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	6151 LAKE OSPREY DR
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8419
Country	:	US
Telephone Number	:	941-907-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	01/08/2014

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