Provider Demographics
NPI:1659604494
Name:HARVIE, LYN CAROLE (DPT,ATC)
Entity Type:Individual
Prefix:DR
First Name:LYN
Middle Name:CAROLE
Last Name:HARVIE
Suffix:
Gender:F
Credentials:DPT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 NW 92ND AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6165
Mailing Address - Country:US
Mailing Address - Phone:248-830-9439
Mailing Address - Fax:
Practice Address - Street 1:9800 WEST COMMERICAL BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-475-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist