Provider Demographics
NPI:1972533800
Name:LYNCH, JOSEPH JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAMES
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 ARIANA AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823
Mailing Address - Country:US
Mailing Address - Phone:863-292-4359
Mailing Address - Fax:863-292-4385
Practice Address - Street 1:200 AVENUE F NE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4131
Practice Address - Country:US
Practice Address - Phone:352-867-8311
Practice Address - Fax:352-867-1053
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97772207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78160OtherBCBS
FL278503000Medicaid
FL278205700Medicaid
FL278205700Medicaid
FLP00435752Medicare PIN
FL278503000Medicaid