Provider Demographics
NPI:1710072673
Name:LYNN, GEOFFREY M (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:M
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-808-8492
Practice Address - Fax:561-501-5144
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL71064208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1241630OtherWELLCARE
FL230482OtherAMERIGROUP
FL3942346OtherCIGNA
FL14394OtherDIMENSION
FL31490OtherBCBS
FLP999149OtherFREEDOM
FL225017OtherAVMED
FL250436700Medicaid
FL5600223OtherAETNA
FL651124093OtherHEALTH CARE DISTRICT
FL060067907OtherRR MEDICARE
FL31490OtherBLUE CROSS BLUE SHIELD
FL33803AOtherMEDICARE GROUP PIN
FLP01606700OtherRR MEDICARE
FLP956408OtherOPTIMUM
FL14394OtherDIMENSION
FL31490YMedicare PIN
FL31490WMedicare PIN