Provider Demographics
NPI:1457505844
Name:ROUEL LINDA MD.FAMILY PRACTICE INC.
Entity Type:Organization
Organization Name:ROUEL LINDA MD.FAMILY PRACTICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ROUEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-283-8882
Mailing Address - Street 1:3426 NW 43RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8105
Mailing Address - Country:US
Mailing Address - Phone:352-283-8882
Mailing Address - Fax:352-338-1415
Practice Address - Street 1:3426 NW 43RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8105
Practice Address - Country:US
Practice Address - Phone:352-283-8882
Practice Address - Fax:352-338-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 98021261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDO8770OtherRR MEDICARE
FLBL913AMedicare PIN