Leivaughn Lyn

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

61754 Issued in FL

Practice address

9197 S Federal Hwy
Port St Lucie, FL 34952-3405

Phone

(772) 335-4668

NPI assigned

Nov 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holiday CVS L.L.C.

  • Pharmacy
  • Wesley Chapel, FL
  • NPI 1770467466
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1659974624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9197 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-335-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9197 S FEDERAL HWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523405",
            "telephone_number": "772-335-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYN",
        "first_name": "LEIVAUGHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "61754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Lukat, PHARM D
• Pedro Luna Jr.
• Soila Diana Luna, COTA
• Judith Lunatinill
• Leo Lundy III, BA
• Christina Lynch
• Lynne C Erbe OD PA
• M & a Psychotherapy
• M&D Residential Services, Inc
• M&R Wellness Center, LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.