Provider Demographics
NPI:1710379417
Name:MENEZES, LYNA MARY (DPT)
Entity Type:Individual
Prefix:
First Name:LYNA
Middle Name:MARY
Last Name:MENEZES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8319 38TH STREET CIR E
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3601
Mailing Address - Country:US
Mailing Address - Phone:941-330-3211
Mailing Address - Fax:
Practice Address - Street 1:8319 38TH STREET CIR E
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3601
Practice Address - Country:US
Practice Address - Phone:941-330-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist