Provider Demographics
NPI:1811458011
Name:LYNCH, ANGELYN RENE (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELYN
Middle Name:RENE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGELYN
Other - Middle Name:RENE
Other - Last Name:THAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6919 N DALE MABRY HWY STE 125
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6919 N DALE MABRY HWY STE 125
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3952
Practice Address - Country:US
Practice Address - Phone:813-558-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1755952086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery