Provider Demographics
NPI:1366469280
Name:LINDO, VERONICA J (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:J
Last Name:LINDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15045 S 6TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-1802
Mailing Address - Country:US
Mailing Address - Phone:480-231-8293
Mailing Address - Fax:
Practice Address - Street 1:15045 S 6TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-1802
Practice Address - Country:US
Practice Address - Phone:480-231-8293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16072207Q00000X
WI67690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1366469280Medicaid
NVPENDINGMedicare PIN