Provider Demographics
NPI:1659312684
Name:LINZER, DOV S (MD)
Entity Type:Individual
Prefix:
First Name:DOV
Middle Name:S
Last Name:LINZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8362 PINES BLVD
Mailing Address - Street 2:STE 271
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6600
Mailing Address - Country:US
Mailing Address - Phone:954-967-6550
Mailing Address - Fax:954-893-6818
Practice Address - Street 1:302 NW 179TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2818
Practice Address - Country:US
Practice Address - Phone:954-450-2100
Practice Address - Fax:954-499-4619
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 70873207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG91065Medicare UPIN
FL46710ZMedicare ID - Type Unspecified