Mount Dora Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME55532 Issued in FL

Legal business name

MOUNT DORA FAMILY PRACTICE PA

Practice address

18540 US Highway 441
Mount Dora, FL 32757-6725

Phone

(352) 383-7743

Fax

(352) 383-9226

NPI assigned

Mar 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Dale Lynch, M.D.

Title

Owner

Phone

(352) 383-7743

Specialties & licenses 1

Addresses

Other identifiers 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Aegis Medical Group LLC

  • Internal Medicine Physician
  • Leesburg, FL
  • NPI 1356769384

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khai Sheng Chang, MD

  • Internal Medicine Physician
  • Mount Dora, FL
  • NPI 1881665222
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1073639969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18540 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576725",
            "telephone_number": "352-383-7743",
            "fax_number": "352-383-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18540 US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576725",
            "telephone_number": "352-383-7743",
            "fax_number": "352-383-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT DORA FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-383-7743",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME55532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA2650",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274649200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahogany Moton, RBT
• Ayham Mouawad, MD
• William David Moulder, P.T.
• Mount Dora Dental & Dentures
• Mount Dora Family Dental PLLC
• Mount Dora Medical Institute Inc LLC
• Mount Dora Ophthalmology ASC LLC
• Mount Dora Physical Therapy Specialists Inc
• Mount Dora Smiles PLLC
• Annette Suzanne Murphy, PA-C

• Family Medicine Physician in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.