Organization
DRLMHENDERSONLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN M. HENDERSON PSY.D (CLINICAL PSYCHOLOGIST)
(727) 422-5368
Entity
Organization
Contact information
Practice address
28870 US HIGHWAY 19 N STE 300, CLEARWATER, FL 33761-4328
(727) 422-5368
(727) 724-4482
Mailing address
551 BAYWOOD DR S, DUNEDIN, FL 34698-2012
(727) 422-5368
(727) 724-4482
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PY8343
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FN118A
MEDICARE PTAN
FL
Enumeration date
01/02/2013
Last updated
04/27/2013
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