Provider Demographics
NPI:1467546671
Name:NETZ, LYNDSEY A (PA-C)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:A
Last Name:NETZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:A
Other - Last Name:METTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-549-0815
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:1223 GATEWAY DR STE 2C
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2607
Practice Address - Country:US
Practice Address - Phone:321-549-0815
Practice Address - Fax:321-768-0039
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108343363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014725200Medicaid
FLIC424ZOtherMEDICARE HF