Provider Demographics
NPI:1649346909
Name:REINERIO LINARES M D P A
Entity type:Organization
Organization Name:REINERIO LINARES M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REINERIO
Authorized Official - Middle Name:
Authorized Official - Last Name:LINARES-MERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-818-8000
Mailing Address - Street 1:3180 CURLEW RD
Mailing Address - Street 2:STE 103
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2629
Mailing Address - Country:US
Mailing Address - Phone:813-818-8000
Mailing Address - Fax:813-818-8005
Practice Address - Street 1:3180 CURLEW RD
Practice Address - Street 2:STE 103
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2629
Practice Address - Country:US
Practice Address - Phone:813-818-8000
Practice Address - Fax:813-818-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70678174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379861500Medicaid
FLG15683Medicare UPIN
FL379861500Medicaid