Provider Demographics
NPI:1568416410
Name:BEAR, LYNETTE M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:M
Last Name:BEAR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:LYNETTE
Other - Middle Name:M
Other - Last Name:SNAUWAERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2721 VIA MURANO UNIT 317
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3974
Mailing Address - Country:US
Mailing Address - Phone:727-410-3111
Mailing Address - Fax:
Practice Address - Street 1:3001 N ROCKY POINT DR E STE 185
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5808
Practice Address - Country:US
Practice Address - Phone:866-362-7574
Practice Address - Fax:813-470-7869
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704176993367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM77150055Medicare PIN