MEDICARE: LINDA S CARUSO ARNP-C

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	363LF0000X	Family Nurse Practitioner	ARNP1628282	FL

General Provider Information

NPI Number	:	1407081771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA S CARUSO ARNP-C

Provider Business Mailing Address
First Line	:	2195 JENKS AVE
Second Line	:	SUITE B
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4682
Country	:	US
Telephone Number	:	850-784-6696
Fax Number	:	850-785-2100

Provider Business Practice Location Address
First Line	:	2195 JENKS AVE
Second Line	:	SUITE B
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4682
Country	:	US
Telephone Number	:	850-784-6696
Fax Number	:	850-785-2100

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

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	05/15/2009

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