Provider Demographics
NPI:1356078653
Name:LYNCH, HAYLEY ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ROSE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 S LAKE BURKETT LN
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9374
Mailing Address - Country:US
Mailing Address - Phone:407-748-8688
Mailing Address - Fax:
Practice Address - Street 1:1717 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2944
Practice Address - Country:US
Practice Address - Phone:407-515-2420
Practice Address - Fax:407-447-4452
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39076225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist