Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lynnette Lallave - Cortes, MD

Individual provider General Practice Physician · NPI 1962022152

Lynnette Lallave - Cortes, MD is a General Practice in Daytona Beach, Florida. Qualified in 2008, 18 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group and accepts Medicare assignment. Licensed in Florida and Puerto Rico.

Years since qualifying
18
Licensed in
FL, PR
In the registry since
2020
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone: (386) 257-1626
Fax: (866) 486-1253
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ACN1425 (FL)
General Practice Physician Taxonomy 208D00000X · Licence 21878 (PR)

Record details

NPI number1962022152
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 17, 2020
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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