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NPI Code Detail

MEDICARE: DR. LINDA JEAN M.D.

MEDICARE: DR. LINDA JEAN M.D.
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
1207Q00000XFamily Medicine PhysicianME114969FL
2207Q00000XFamily Medicine Physician067653GA

General Provider Information

NPI Number : 1376862987
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA JEAN M.D.
Provider Business Mailing Address
First Line : 601 S HARBOUR ISLAND BLVD STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33602-5925
Country : US
Telephone Number : 863-215-6639
Fax Number : 844-388-6186
Provider Business Practice Location Address
First Line : 750 S FEDERAL HWY
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33020-5424
Country : US
Telephone Number : 954-342-8800
Fax Number : 954-342-8700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2010
Last Update Date : 08/04/2022

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