Individual
LYNN VAN UMMERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
765 IMAGE WAY, ORANGE CITY, FL 32763-8399
(386) 774-7411
(386) 774-7412
Mailing address
PO BOX 102222, ATTN: CREDENTIAL DEPARTMENT, ATLANTA, GA 30368-2222
(239) 432-8339
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
99045
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000924400
—
FL
Enumeration date
03/28/2006
Last updated
08/30/2023
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