Healthcare Provider Details

I. General information

NPI: 1235200445
Provider Name (Legal Business Name): LINDA L. STONE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W MICHIGAN ST
ORLANDO FL
32805-6203
US

IV. Provider business mailing address

1175 WASHINGTON AVE
WINTER PARK FL
32789-5656
US

V. Phone/Fax

Practice location:
  • Phone: 407-317-7430
  • Fax: 407-648-4150
Mailing address:
  • Phone: 407-629-2892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS52
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: