MEDICARE: DR LYNN FAMILY PRACTICE 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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1558495382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR LYNN FAMILY PRACTICE PA

Provider Business Mailing Address
First Line	:	1323 W FLETCHER AVE STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1323 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:	813-999-2188
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. LON DAVID LYNN
Credential	:	D.O.
Telephone Number	:	813-264-7922

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	09/28/2021

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