Provider Demographics
NPI:1982843520
Name:LINDA CANCELA MARINO, DIPL. AC., INC.
Entity Type:Organization
Organization Name:LINDA CANCELA MARINO, DIPL. AC., INC.
Other - Org Name:LINDA MARINO ACUPUNCTURE & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:CANCELA
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DIPL AC, AP
Authorized Official - Phone:239-514-4351
Mailing Address - Street 1:2180 IMMOKALEE RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1421
Mailing Address - Country:US
Mailing Address - Phone:239-514-4351
Mailing Address - Fax:
Practice Address - Street 1:2180 IMMOKALEE RD
Practice Address - Street 2:SUITE 312
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1421
Practice Address - Country:US
Practice Address - Phone:239-514-4351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP-2079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty