Provider Demographics
NPI:1033774864
Name:DUNCAN, LINDSEY T (PA)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:T
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W COPELAND DR
Mailing Address - Street 2:1ST FL
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2101
Mailing Address - Country:US
Mailing Address - Phone:321-841-7090
Mailing Address - Fax:321-843-2267
Practice Address - Street 1:265 E ROLLINS ST STE 5300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5519
Practice Address - Country:US
Practice Address - Phone:407-821-3555
Practice Address - Fax:407-821-3556
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112313363A00000X, 363AS0400X
363A00000X
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103773800Medicaid