Provider Demographics
NPI:1083611545
Name:LYNN, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE #9700
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3404
Mailing Address - Country:US
Mailing Address - Phone:561-655-1877
Mailing Address - Fax:561-655-6404
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE #9700
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-655-1877
Practice Address - Fax:561-655-6404
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME254172086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057506200Medicaid
D55823Medicare UPIN
50760Medicare ID - Type Unspecified