MEDICARE: LINDA GAIL KING D.O.

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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	OS4299	FL

General Provider Information

NPI Number	:	1336364322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA GAIL KING D.O.

Provider Business Mailing Address
First Line	:	1349 S INTERNATIONAL PKWY
Second Line	:	SUITE 1431
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1697
Country	:	US
Telephone Number	:	407-333-3372
Fax Number	:	407-333-3672

Provider Business Practice Location Address
First Line	:	1349 S INTERNATIONAL PKWY
Second Line	:	SUITE 1431
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1697
Country	:	US
Telephone Number	:	407-333-3372
Fax Number	:	407-333-3672

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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