Provider Demographics
NPI:1043467236
Name:LINDA MARRACCINI MD PA
Entity Type:Organization
Organization Name:LINDA MARRACCINI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRACCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-666-8858
Mailing Address - Street 1:6280 SUNSET DR
Mailing Address - Street 2:SUITE 407
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4827
Mailing Address - Country:US
Mailing Address - Phone:305-666-8858
Mailing Address - Fax:305-665-1731
Practice Address - Street 1:6280 SUNSET DR
Practice Address - Street 2:SUITE 407
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4827
Practice Address - Country:US
Practice Address - Phone:305-666-8858
Practice Address - Fax:305-665-1731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty