Provider Demographics
NPI:1609919463
Name:DOSS, LINDA MARKS (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARKS
Last Name:DOSS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:LOY
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:542069 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:CALLAHAN
Mailing Address - State:FL
Mailing Address - Zip Code:32011-8110
Mailing Address - Country:US
Mailing Address - Phone:904-879-2020
Mailing Address - Fax:904-879-6401
Practice Address - Street 1:542069 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:CALLAHAN
Practice Address - State:FL
Practice Address - Zip Code:32011-8110
Practice Address - Country:US
Practice Address - Phone:904-879-2020
Practice Address - Fax:904-879-6401
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3024152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU74481Medicare UPIN
FLE2290VMedicare ID - Type Unspecified