Healthcare Provider Details
I. General information
NPI: 1033107115
Provider Name (Legal Business Name): LINDA DOLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/12/2005
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7777 GLADES ROAD STE 100
BOCA RATON FL
33434-4150
US
IV. Provider business mailing address
7777 GLADES ROAD STE 100
BOCA RATON FL
33434-4150
US
V. Phone/Fax
- Phone: 561-573-3495
- Fax: 888-910-3040
- Phone: 561-573-3495
- Fax: 888-910-3040
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | ME56018 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0000X |
| Taxonomy | Adolescent Medicine (Internal Medicine) Physician |
| License Number | ME56018 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: