MEDICARE: MRS. LINDA A MACALLISTER

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	:	1952597601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA A MACALLISTER

Provider Business Mailing Address
First Line	:	PO BOX 27102
Second Line	:
City	:	EL JOBEAN
State	:	FL
Zip	:	33927-7102
Country	:	US
Telephone Number	:	941-662-0603
Fax Number	:	941-697-9500

Provider Business Practice Location Address
First Line	:	13212 FELDSPAR AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33981-1817
Country	:	US
Telephone Number	:	941-662-0603
Fax Number	:	941-697-9500

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

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	09/17/2007

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