Provider Demographics
NPI:1427401629
Name:PERRINE, LYNN MARIE (DOM, LAC, RN)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:PERRINE
Suffix:
Gender:F
Credentials:DOM, LAC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 560576
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-0576
Mailing Address - Country:US
Mailing Address - Phone:305-742-8434
Mailing Address - Fax:
Practice Address - Street 1:9420 SW 77TH AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-2501
Practice Address - Country:US
Practice Address - Phone:305-742-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL787172163W00000X
FL1124171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse