Provider Demographics
NPI:1336312925
Name:LINARDOS, LEONARD M (DC)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:M
Last Name:LINARDOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:LENNY
Other - Middle Name:M
Other - Last Name:LINARDOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1817 US HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-5536
Mailing Address - Country:US
Mailing Address - Phone:727-937-6422
Mailing Address - Fax:727-937-6769
Practice Address - Street 1:1817 US HIGHWAY 19
Practice Address - Street 2:1817 US HWY 19 SOUTH
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-5536
Practice Address - Country:US
Practice Address - Phone:727-937-6422
Practice Address - Fax:727-937-6769
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8507111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1336312925Medicaid
FL381634600Medicaid