Healthcare Provider Details

I. General information

NPI: 1154386449
Provider Name (Legal Business Name): LINDA S CRUSE D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 TOWER ST
LAKE PLACID FL
33852-6836
US

IV. Provider business mailing address

145 TOWER ST
LAKE PLACID FL
33852-6836
US

V. Phone/Fax

Practice location:
  • Phone: 863-465-9991
  • Fax: 863-465-9906
Mailing address:
  • Phone: 863-465-9991
  • Fax: 863-465-9906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPT19782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: