Provider Demographics
NPI:1467919332
Name:KOVAR, LYNNETTE JOANNE
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:JOANNE
Last Name:KOVAR
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 1:1166 THOMASVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-3403
Mailing Address - Country:US
Mailing Address - Phone:863-255-1342
Mailing Address - Fax:
Practice Address - Street 1:1166 THOMASVILLE CIR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-3403
Practice Address - Country:US
Practice Address - Phone:863-255-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator