Provider Demographics
NPI:1164426912
Name:LINZER, HOWARD (DO)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:LINZER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8223 E THOMAS RD
Mailing Address - Street 2:STE 303
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-9601
Mailing Address - Country:US
Mailing Address - Phone:727-744-9040
Mailing Address - Fax:480-380-5053
Practice Address - Street 1:6400 DAVIS BLVD
Practice Address - Street 2:STE 103
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5321
Practice Address - Country:US
Practice Address - Phone:239-775-2300
Practice Address - Fax:239-775-4312
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258604500Medicaid
FLH08999Medicare UPIN
FLE3514YMedicare ID - Type Unspecified