Provider Demographics
NPI:1659340800
Name:ROGERS, LINDA L (CASEMANAGER)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CASEMANAGER
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:COON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASEMANAGER
Mailing Address - Street 1:1290 GOLFVIEW AVE
Mailing Address - Street 2:ATTN: BILLING DEPARTMENT
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6738
Mailing Address - Country:US
Mailing Address - Phone:863-519-7900
Mailing Address - Fax:863-519-7696
Practice Address - Street 1:1255 BRICE BLVD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6735
Practice Address - Country:US
Practice Address - Phone:863-519-8233
Practice Address - Fax:863-499-2612
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker