Healthcare Provider Details

I. General information

NPI: 1063495208
Provider Name (Legal Business Name): LINDA J WARE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. LINDA J MILLER

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10831 SW 67TH AVE
OCALA FL
34476-9345
US

IV. Provider business mailing address

8625 SW 54TH CT
OCALA FL
34476-9444
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-3800
  • Fax: 352-873-4800
Mailing address:
  • Phone: 352-873-2305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9291202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: