Individual
LYNSEY SOUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
102 PARK PLACE BLVD, DAVENPORT, FL 33837-6857
(863) 422-0032
Mailing address
102 PARK PLACE BLVD, DAVENPORT, FL 33837-6857
(863) 422-0032
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
PA9111124
FL
Other
Enumeration date
07/11/2018
Last updated
05/08/2023
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