MEDICARE: MS. LINDA L FROST L.E., L.L.C.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	374700000X	Technician	271303347	AZ

General Provider Information

NPI Number	:	1962770198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA L FROST L.E., L.L.C.C.

Provider Business Mailing Address
First Line	:	6890 E SUNRISE DR #120
Second Line	:	PMB 472
City	:	TUCSON
State	:	AZ
Zip	:	85750-0739
Country	:	US
Telephone Number	:	520-400-6763
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 N TUCSON BLVD STE 37
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3410
Country	:	US
Telephone Number	:	520-400-6763
Fax Number	:

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

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	08/04/2020

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