Provider Demographics
NPI:1295917979
Name:FORD, LINDA M (RPT,CHT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:FORD
Suffix:
Gender:F
Credentials:RPT,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 106
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-225-4680
Mailing Address - Fax:787-998-3723
Practice Address - Street 1:201 AVE DE DIEGO
Practice Address - Street 2:SUITE 213
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5812
Practice Address - Country:US
Practice Address - Phone:787-225-4680
Practice Address - Fax:787-998-3723
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5322251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0084138Medicare PIN