MEDICARE: DR. LINDA F MASCETTI PH.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
1	103TC0700X	Clinical Psychologist	PS002330L	PA

General Provider Information

NPI Number	:	1801890348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA F MASCETTI PH.D.

Provider Business Mailing Address
First Line	:	1258 LYNDHURST GREENS DR
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-7160
Country	:	US
Telephone Number	:	813-938-4119
Fax Number	:

Provider Business Practice Location Address
First Line	:	1258 LYNDHURST GREENS DR
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-7160
Country	:	US
Telephone Number	:	813-938-4119
Fax Number	:

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	07/19/2007

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