Provider Demographics
NPI:1376765347
Name:ELMORE, LINDA F
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:ELMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:
Mailing Address - City:LACOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33537
Mailing Address - Country:US
Mailing Address - Phone:352-583-0576
Mailing Address - Fax:
Practice Address - Street 1:12649 US HWY 301
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525
Practice Address - Country:US
Practice Address - Phone:352-523-2930
Practice Address - Fax:352-523-2936
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL300101041159907247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other