MEDICARE: MRS. LINDA ROSS KUSHNER MA CCC, SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA 1789	FL

General Provider Information

NPI Number	:	1063621274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA ROSS KUSHNER MA CCC, SLP

Provider Business Mailing Address
First Line	:	500 VILLAGE SQUARE CROSSING
Second Line	:	SUITE 201
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410
Country	:	US
Telephone Number	:	561-627-7899
Fax Number	:	561-318-7827

Provider Business Practice Location Address
First Line	:	500 VILLAGE SQUARE CROSSING
Second Line	:	SUITE 201
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4548
Country	:	US
Telephone Number	:	561-627-7899
Fax Number	:	561-318-7827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	02/14/2012

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