Provider Demographics
NPI:1689788622
Name:LYNCH, CARMEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5544 DEEPDALE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-7630
Mailing Address - Country:US
Mailing Address - Phone:407-744-1444
Mailing Address - Fax:407-238-0147
Practice Address - Street 1:5544 DEEPDALE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-7630
Practice Address - Country:US
Practice Address - Phone:407-744-1444
Practice Address - Fax:407-238-0147
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22953ZOtherMEDICARE ID
FL22953ZOtherMEDICARE ID
FL00038450Medicare PIN