Provider Demographics
NPI:1740215359
Name:VICTOR-LINKENHOKER, VANESSA R (MD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:R
Last Name:VICTOR-LINKENHOKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9246 13TH AVENUE CIR NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-8304
Mailing Address - Country:US
Mailing Address - Phone:941-795-8588
Mailing Address - Fax:941-795-5508
Practice Address - Street 1:5115 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3740
Practice Address - Country:US
Practice Address - Phone:941-795-8588
Practice Address - Fax:941-795-5508
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69945174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG34338Medicare UPIN