Provider Demographics
NPI:1265779169
Name:CARL, LYNETTE LOUISE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:LOUISE
Last Name:CARL
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 HARBOR DR N
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-3115
Mailing Address - Country:US
Mailing Address - Phone:727-359-0400
Mailing Address - Fax:
Practice Address - Street 1:10901 ROOSEVELT BLVD N STE 400
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-2305
Practice Address - Country:US
Practice Address - Phone:727-359-0040
Practice Address - Fax:727-851-9898
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL144471835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy