Provider Demographics
NPI:1023610623
Name:LYNCH, MICHAEL PATRICK
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:LYNCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29722 FOG HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6776
Mailing Address - Country:US
Mailing Address - Phone:813-777-1985
Mailing Address - Fax:
Practice Address - Street 1:30051 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-6778
Practice Address - Country:US
Practice Address - Phone:813-991-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer