Healthcare Provider Details

I. General information

NPI: 1831915636
Provider Name (Legal Business Name): LINDA LAVERNE HOLLINGSHEAD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15757 PINES BLVD # 184
PEMBROKE PINES FL
33027-1207
US

IV. Provider business mailing address

16394 NW 13TH ST
PEMBROKE PINES FL
33028-1307
US

V. Phone/Fax

Practice location:
  • Phone: 786-499-6980
  • Fax:
Mailing address:
  • Phone: 786-499-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11036602
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11036602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: