Individual
BARLOW ST CLAIR LYNCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
699 W COCOA BEACH CSWY STE 506, COCOA BEACH, FL 32931-3562
(321) 631-2070
Mailing address
7321 HANOVER PKWY, GREENBELT, MD 20770-3616
(301) 474-1324
(301) 474-1327
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036147923
IL
208800000X
Urology Physician
D30609
MD
208800000X
Urology Physician
Primary
ME136412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112274100
—
FL
05
—
351561300
—
DC
01
—
OI025
MEDICARE HF
FL
Enumeration date
12/28/2005
Last updated
11/03/2021
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