Provider Demographics
NPI:1154582658
Name:THELMA F. LYNCH, RN, PH.D., PA
Entity type:Organization
Organization Name:THELMA F. LYNCH, RN, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.
Authorized Official - Prefix:DR
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:F
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHD, PA
Authorized Official - Phone:407-695-3664
Mailing Address - Street 1:1806 TOWN PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6206
Mailing Address - Country:US
Mailing Address - Phone:407-695-3664
Mailing Address - Fax:407-695-3674
Practice Address - Street 1:1806 TOWN PLAZA CT
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6206
Practice Address - Country:US
Practice Address - Phone:407-695-3664
Practice Address - Fax:407-695-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6447103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54858OtherBCBS
FL54828ZMedicare PIN