MEDICARE: LYNN A SUMMERS, LLC

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	235Z00000X	Speech-Language Pathologist	SA8774	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1477984870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNN A SUMMERS, LLC

Provider Business Mailing Address
First Line	:	5733 RIVERBOAT CIR SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-7524
Country	:	US
Telephone Number	:	772-492-3975
Fax Number	:	772-925-8259

Provider Business Practice Location Address
First Line	:	5733 RIVERBOAT CIR SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-7524
Country	:	US
Telephone Number	:	772-492-3975
Fax Number	:	772-925-8259

Authorized Official
Title or Position	:	OWNER
Name	:	LYNN ANN APPLEBEE
Credential	:
Telephone Number	:	772-492-3975

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	09/16/2020

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Directions to “LYNN A SUMMERS, LLC ” Practice Location

Language	Start Address	Practice Location

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