MEDICARE: ELINA LINDERMAN

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	251X00000X	Supports Brokerage Agency	W176693	FL

General Provider Information

NPI Number	:	1881016228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELINA LINDERMAN

Provider Business Mailing Address
First Line	:	30407 PRINCESS BAY DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4211
Country	:	US
Telephone Number	:	727-688-8421
Fax Number	:

Provider Business Practice Location Address
First Line	:	30407 PRINCESS BAY DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4211
Country	:	US
Telephone Number	:	727-688-8421
Fax Number	:

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

Provider Enumeration Date	:	01/18/2014
Last Update Date	:	01/18/2014

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