Individual
LYNN TATYANA JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
921 E PARKER ST STE 4, LAKELAND, FL 33801-1901
(941) 448-8105
Mailing address
1341 MAGDALENE CT W, LAKELAND, FL 33801-2982
(941) 448-8105
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019875400
—
FL
Enumeration date
06/30/2017
Last updated
07/08/2020
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