Provider Demographics
NPI:1851398945
Name:LINZER, DEBRA L (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:L
Last Name:LINZER
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 1:4450 MANGRUM COURT
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-649-2301
Mailing Address - Fax:786-428-0305
Practice Address - Street 1:20950 NE 27TH CT
Practice Address - Street 2:SUITE 300
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1232
Practice Address - Country:US
Practice Address - Phone:786-428-0303
Practice Address - Fax:786-428-0305
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00708692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250189900Medicaid
FL7299859OtherGHI PROVIDER NUMBER
FL1098818OtherFIRST HEALTH PROVIDER #
FL17915OtherTOTAL HLTHCH. PROVIDER #
FL4452999-002OtherCIGNA PROVIDER NUMBER
FL5768746OtherAETNA PROVIDER NUMBER
FL8892OtherDIMENSION PROVIDER NUMBER
FL31453OtherBCBS PROVIDER NUMBER
FL330727OtherUSA MNGD CR. PROVIDER #
FL162771OtherWELLCARE PROVIDER NUMBER
FL209194OtherAMERIGROUP PROVIDER NUM.
FL162771OtherWELLCARE PROVIDER NUMBER
FL8892OtherDIMENSION PROVIDER NUMBER