Provider Demographics
NPI:1336448133
Name:BOONE, LINDSEY ELIZABETH (ARNP)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:BOONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 BUGLE ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5418
Mailing Address - Country:US
Mailing Address - Phone:305-336-4877
Mailing Address - Fax:
Practice Address - Street 1:4701 S FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-2312
Practice Address - Country:US
Practice Address - Phone:407-473-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004708200Medicaid
FL004708200Medicaid