Provider Demographics
NPI:1043791742
Name:LYNCH, ANNA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 W FLAGLER ST STE 901
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1894
Mailing Address - Country:US
Mailing Address - Phone:305-331-2277
Mailing Address - Fax:305-424-9361
Practice Address - Street 1:28 W FLAGLER ST STE 901
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1894
Practice Address - Country:US
Practice Address - Phone:305-331-2277
Practice Address - Fax:305-424-9361
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPT.92812251P0200X
FLPT34594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT34594OtherPT LICENSE
SCPT.9281OtherSOUTH CAROLINA PT LICENSE