Provider Demographics
NPI:1346279577
Name:MADARIS, LINDA L (APRN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:MADARIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 CAMELLIA CT
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-5701
Mailing Address - Country:US
Mailing Address - Phone:813-685-8758
Mailing Address - Fax:813-685-8758
Practice Address - Street 1:701 CAMELLIA CT
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-5701
Practice Address - Country:US
Practice Address - Phone:813-610-7747
Practice Address - Fax:813-685-8758
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN765422363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology