Basic Information
Provider Information
NPI: 1063743680
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ORATOKHAI
FirstName: LYNTHIA
MiddleName: T
NamePrefix: MS.
NameSuffix:  
Credential: R.N., B.S.N
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2200 RINGLING BLVD
Address2:  
City: SARASOTA
State: FL
PostalCode: 342376102
CountryCode: US
TelephoneNumber: 9418612900
FaxNumber: 9418612719
Practice Location
Address1: 2200 RINGLING BLVD
Address2:  
City: SARASOTA
State: FL
PostalCode: 342376102
CountryCode: US
TelephoneNumber: 9418612900
FaxNumber: 9418612719
Other Information
ProviderEnumerationDate: 01/21/2010
LastUpdateDate: 01/21/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WA2000XRN1667272FLY Nursing Service ProvidersRegistered NurseAdministrator
171M00000XRN1667272FLN Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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