Basic Information
Provider Information
NPI: 1528464161
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANKERT
FirstName: LINDSAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AAC
OtherOrganizationName:  
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Mailing Information
Address1: 1775 W HIBISCUS BLVD
Address2: SUITE 215
City: MELBOURNE
State: FL
PostalCode: 329012620
CountryCode: US
TelephoneNumber: 3218373820
FaxNumber: 3218373654
Practice Location
Address1: 1775 W HIBISCUS BLVD
Address2: SUITE 215
City: MELBOURNE
State: FL
PostalCode: 329012620
CountryCode: US
TelephoneNumber: 3218373820
FaxNumber: 3218373654
Other Information
ProviderEnumerationDate: 11/10/2014
LastUpdateDate: 02/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000XAA 294FLY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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