MEDICARE: LINDA CICHON

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1508181280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA CICHON

Provider Business Mailing Address
First Line	:	PO BOX 350446
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33335-0446
Country	:	US
Telephone Number	:	954-765-0550
Fax Number	:	954-765-0587

Provider Business Practice Location Address
First Line	:	1100 W STATE ROAD 84
Second Line	:	2ND FLOOR
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33315-2436
Country	:	US
Telephone Number	:	954-765-0550
Fax Number	:	954-765-0587

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

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	04/06/2010

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Directions to “ LINDA CICHON ” Practice Location

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