Provider Demographics
NPI:1841833852
Name:LYNCH, DAVID JOSEPH (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:LYNCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12855 CORAL LAKES DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-4182
Mailing Address - Country:US
Mailing Address - Phone:612-250-4486
Mailing Address - Fax:
Practice Address - Street 1:3155 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3221
Practice Address - Country:US
Practice Address - Phone:561-450-3021
Practice Address - Fax:561-450-3022
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038120183500000X
FLPS54380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS54380OtherPHARMACIST LICENSE
NY038120OtherPHARMACIST LICENSE