Provider Demographics
NPI:1780742676
Name:LYNN R BERNSTEIN & ASSOCIATES PA
Entity type:Organization
Organization Name:LYNN R BERNSTEIN & ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRI
Authorized Official - Middle Name:I
Authorized Official - Last Name:DOUTHWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-474-7170
Mailing Address - Street 1:1861 PLACIDA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4900
Mailing Address - Country:US
Mailing Address - Phone:941-474-7170
Mailing Address - Fax:941-475-2955
Practice Address - Street 1:1861 PLACIDA RD STE 101
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4900
Practice Address - Country:US
Practice Address - Phone:941-474-7170
Practice Address - Fax:941-475-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3297103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033111200Medicaid
FL033111200Medicaid