Provider Demographics
NPI:1316690803
Name:LINDSAY, CODY (AA)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:AA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2627 W EAU GALLIE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8303
Mailing Address - Country:US
Mailing Address - Phone:321-837-3820
Mailing Address - Fax:636-200-4243
Practice Address - Street 1:2627 W EAU GALLIE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8303
Practice Address - Country:US
Practice Address - Phone:321-837-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant