Provider Demographics
NPI:1396255147
Name:LIND, MEGAN CAROLE (PA-C)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:CAROLE
Last Name:LIND
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2770 SABAL ALEXANDER CIR APT 200
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3729
Mailing Address - Country:US
Mailing Address - Phone:908-892-1462
Mailing Address - Fax:
Practice Address - Street 1:255 N LAKEMONT AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3229
Practice Address - Country:US
Practice Address - Phone:321-206-5972
Practice Address - Fax:407-303-2781
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2021-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY021498363A00000X
NJ25MP00449600363A00000X
FLPA9113779363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant