Provider Demographics
NPI:1750456422
Name:BEAUMONT, LYNNE (PT)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LYNNE
Other - Middle Name:
Other - Last Name:BEAUMONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:131 DATE PALM DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3571
Mailing Address - Country:US
Mailing Address - Phone:561-512-5755
Mailing Address - Fax:561-863-4220
Practice Address - Street 1:131 DATE PALM DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3571
Practice Address - Country:US
Practice Address - Phone:561-512-5755
Practice Address - Fax:561-863-4220
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist