Provider Demographics
NPI:1154338663
Name:SCHRAM, LYNN LAVERN (PHD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:LAVERN
Last Name:SCHRAM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:9TH FLOOR, SUITE 910
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2840
Mailing Address - Country:US
Mailing Address - Phone:305-534-3636
Mailing Address - Fax:305-534-1421
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:9TH FLOOR, SUITE 910
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2840
Practice Address - Country:US
Practice Address - Phone:305-534-3636
Practice Address - Fax:305-534-1421
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY48442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59609Medicare ID - Type UnspecifiedPROVIDER NUMBER