Healthcare Provider Details

I. General information

NPI: 1942469812
Provider Name (Legal Business Name): JOSHUA DAVID LINNELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 US HIGHWAY 98 S STE 101-102
LAKELAND FL
33812-4334
US

IV. Provider business mailing address

5901 E FOWLER AVE STE 100
TEMPLE TERRACE FL
33617-2305
US

V. Phone/Fax

Practice location:
  • Phone: 863-274-9700
  • Fax:
Mailing address:
  • Phone: 813-978-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME164026
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberME164026
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: