Healthcare Provider Details

I. General information

NPI: 1801890348
Provider Name (Legal Business Name): LINDA F MASCETTI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 07/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 LYNDHURST GREENS DR
SUN CITY CENTER FL
33573-7160
US

IV. Provider business mailing address

1258 LYNDHURST GREENS DR
SUN CITY CENTER FL
33573-7160
US

V. Phone/Fax

Practice location:
  • Phone: 813-938-4119
  • Fax:
Mailing address:
  • Phone: 813-938-4119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS002330L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: