Provider Demographics
NPI:1184687436
Name:LYNCH, LISA GESTEWITZ (MHS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GESTEWITZ
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N PALMWAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3515
Mailing Address - Country:US
Mailing Address - Phone:561-588-1138
Mailing Address - Fax:
Practice Address - Street 1:126 N PALMWAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-3515
Practice Address - Country:US
Practice Address - Phone:561-588-1138
Practice Address - Fax:561-277-2553
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11383225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ095QOtherBLUECROSS BLUESHIELD