MEDICARE: DR. STANLEY LYNN DULL PSY.D

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	103TC0700X	Clinical Psychologist	PS 6616	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	:	1548537574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY LYNN DULL PSY.D

Provider Business Mailing Address
First Line	:	2215 PALM TREE DR
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-5007
Country	:	US
Telephone Number	:	941-637-5932
Fax Number	:

Provider Business Practice Location Address
First Line	:	2215 PALM TREE DR
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-5007
Country	:	US
Telephone Number	:	941-637-5932
Fax Number	:

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

Provider Enumeration Date	:	11/18/2011
Last Update Date	:	11/18/2011

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