Provider Demographics
NPI:1073764338
Name:BRIDE, LYNDSEY K (AUD)
Entity Type:Individual
Prefix:DR
First Name:LYNDSEY
Middle Name:K
Last Name:BRIDE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:K
Other - Last Name:NALU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:11041 GATEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4916
Mailing Address - Country:US
Mailing Address - Phone:941-312-4781
Mailing Address - Fax:
Practice Address - Street 1:11041 GATEWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34211
Practice Address - Country:US
Practice Address - Phone:941-312-4781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1602231H00000X
MI1601000522231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist