Provider Demographics
NPI:1891870747
Name:RICH-CONSIGLIO, LINDA PAMELA (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:PAMELA
Last Name:RICH-CONSIGLIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1452 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4853
Mailing Address - Country:US
Mailing Address - Phone:813-409-3888
Mailing Address - Fax:
Practice Address - Street 1:1452 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4853
Practice Address - Country:US
Practice Address - Phone:813-409-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU22997Medicare UPIN