Provider Demographics
NPI:1437456142
Name:CRONIN, LYNN ZENA
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ZENA
Last Name:CRONIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 LYNNE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-6113
Mailing Address - Country:US
Mailing Address - Phone:386-672-0720
Mailing Address - Fax:
Practice Address - Street 1:50 S YONGE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8825
Practice Address - Country:US
Practice Address - Phone:386-672-0720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA60554225700000X
FLMM25979225700000X
FL570281-09225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist