MEDICARE: DR. LYNA CAMPO M.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	207R00000X	Internal Medicine Physician	294388	NY
2	207R00000X	Internal Medicine Physician	ME140818	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	:	1790193746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNA CAMPO M.D.

Provider Business Mailing Address
First Line	:	200 AVENUE F NE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-4193
Country	:	US
Telephone Number	:	863-293-1121
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 AVENUE F NE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881
Country	:	US
Telephone Number	:	863-293-1121
Fax Number	:

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

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	05/20/2026

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Directions to “ DR. LYNA CAMPO M.D.” Practice Location

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