Provider Demographics
NPI:1265536791
Name:BIANCO, LINDA FRANK (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:FRANK
Last Name:BIANCO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-2530
Mailing Address - Country:US
Mailing Address - Phone:850-627-9261
Mailing Address - Fax:850-875-2676
Practice Address - Street 1:300 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-2530
Practice Address - Country:US
Practice Address - Phone:850-627-9261
Practice Address - Fax:850-875-2676
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1120972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE3131XMedicare ID - Type Unspecified
FLS90177Medicare UPIN