Provider Demographics
NPI:1689345126
Name:FALCONE, LYNNE MARIE
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:FALCONE
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 1:4102 CENTRAL SARASOTA PKWY APT 914
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5685
Mailing Address - Country:US
Mailing Address - Phone:401-742-4719
Mailing Address - Fax:
Practice Address - Street 1:4102 CENTRAL SARASOTA PKWY APT 914
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5685
Practice Address - Country:US
Practice Address - Phone:401-742-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26028225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant