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General NPI Number Information
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NPI Number | 1407249329
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Entity Type | Organization
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Legal Business Name | LINKPHYSICIANSERVICES,LLC
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 7655 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1263
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Country | US
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Telephone | 727-698-0557
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Fax |
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Provider Business Mailing Address
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Address Line | 7655 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1263
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Country | US
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Telephone | 727-698-0557
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RANDY ALLEN SHUCK
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Credential | DO
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Telephone | 727-698-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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