MEDICARE: MRS. LINDA D THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1265617252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA D THOMAS

Provider Business Mailing Address
First Line	:	165 WEKIVA SPRINGS RD
Second Line	:	SUITE 167
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6051
Country	:	US
Telephone Number	:	407-222-9898
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 WEKIVA SPRINGS RD
Second Line	:	SUITE 167
City	:	LONGWOOD
State	:	FL
Zip	:	32779-6051
Country	:	US
Telephone Number	:	407-222-9898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	01/08/2008

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