Provider Demographics
NPI:1285809517
Name:SEDWICK, LYN A (MD)
Entity type:Individual
Prefix:DR
First Name:LYN
Middle Name:A
Last Name:SEDWICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5531
Mailing Address - Country:US
Mailing Address - Phone:407-896-8996
Mailing Address - Fax:407-896-6034
Practice Address - Street 1:1900 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5531
Practice Address - Country:US
Practice Address - Phone:407-896-8996
Practice Address - Fax:407-896-6034
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37548174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79798Medicare PIN
FLD58927Medicare UPIN