Provider Demographics
NPI:1134486665
Name:LINDER, VICTORIA NICOLE (PTA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NICOLE
Last Name:LINDER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 RIVER BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4214
Mailing Address - Country:US
Mailing Address - Phone:561-573-2397
Mailing Address - Fax:
Practice Address - Street 1:2939 S HAVERHILL RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-8118
Practice Address - Country:US
Practice Address - Phone:561-641-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-22
Last Update Date:2012-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22026208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation