Provider Demographics
NPI:1578739702
Name:AVELINO, LYNDON DAYAO (BSN, RN)
Entity Type:Individual
Prefix:MR
First Name:LYNDON
Middle Name:DAYAO
Last Name:AVELINO
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 W LAMAR RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303-7617
Mailing Address - Country:US
Mailing Address - Phone:623-242-9661
Mailing Address - Fax:623-242-9661
Practice Address - Street 1:7230 W LAMAR RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303-7617
Practice Address - Country:US
Practice Address - Phone:623-242-9661
Practice Address - Fax:623-242-9661
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN096243163WH0200X, 163WM0705X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic