Provider Demographics
NPI:1033886262
Name:LYNDE, TAMELA R
Entity Type:Individual
Prefix:
First Name:TAMELA
Middle Name:R
Last Name:LYNDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 SATSUMA ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3605
Mailing Address - Country:US
Mailing Address - Phone:214-663-5974
Mailing Address - Fax:
Practice Address - Street 1:1527 SATSUMA ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3605
Practice Address - Country:US
Practice Address - Phone:214-663-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider