Basic Information
| Provider Information | |||||||||
| NPI: | 1972533800 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LYNCH | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 134 ARIANA AVE | ||||||||
| Address2: | |||||||||
| City: | AUBURNDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632924359 | ||||||||
| FaxNumber: | 8632924385 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 AVENUE F NE | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338814131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3528678311 | ||||||||
| FaxNumber: | 3528671053 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 08/07/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | ME97772 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | ME97772 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 78160 | 01 | FL | BCBS | OTHER | 278503000 | 05 | FL | MEDICAID | 278205700 | 05 | FL | MEDICAID |