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NPI 1063481240

NPI 1063481240 : MICHAEL L. LINETT D.O. : FT LAUDERDALE, FL

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General NPI Number Information
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    NPI Number           |    1063481240
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL L. LINETT D.O.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/17/2006
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    Last Update Date     |    12/02/2009
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Provider Practice Location Address
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    Address Line         |    6401 N FEDERAL HWY EMERGENCY DEPARTMENT
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    City                 |    FT LAUDERDALE
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    State                |    FL
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    Zip                  |    33308-1427
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    Country              |    US
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    Telephone            |    919-425-1565
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    Fax                  |    919-425-0478
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Provider Business Mailing Address
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    Address Line         |    3114 CROASDAILE DR SUITE 200
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    City                 |    DURHAM
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    State                |    NC
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    Zip                  |    27705-2508
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    Country              |    US
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    Telephone            |    919-425-1565
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    Fax                  |    919-425-0478
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    227934-1
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    License Number State |    NY
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