Provider Demographics
NPI:1023109550
Name:GASKINS, LYNN A (MD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:GASKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 LITHIA CENTER LN
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5676
Mailing Address - Country:US
Mailing Address - Phone:813-662-0123
Mailing Address - Fax:813-662-9422
Practice Address - Street 1:2237 LITHIA CENTER LN
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-5676
Practice Address - Country:US
Practice Address - Phone:813-662-0123
Practice Address - Fax:813-662-9422
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
07664VMedicare ID - Type Unspecified
FLB65493Medicare UPIN