Provider Demographics
NPI:1437138104
Name:VARISCO, LINDA D (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:VARISCO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W OAKLAND PARK BLVD
Mailing Address - Street 2:#202
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1016
Mailing Address - Country:US
Mailing Address - Phone:954-572-1099
Mailing Address - Fax:954-572-4409
Practice Address - Street 1:7000 W OAKLAND PARK BLVD
Practice Address - Street 2:#202
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1016
Practice Address - Country:US
Practice Address - Phone:954-572-1099
Practice Address - Fax:954-572-4409
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBLUECROSS BLUE SHIELOther74970
FLBLUECROSS BLUE SHIELOther74970