Provider Demographics
NPI:1801890348
Name:MASCETTI, LINDA F (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:F
Last Name:MASCETTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 LYNDHURST GREENS DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-7160
Mailing Address - Country:US
Mailing Address - Phone:813-938-4119
Mailing Address - Fax:
Practice Address - Street 1:1258 LYNDHURST GREENS DR
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-7160
Practice Address - Country:US
Practice Address - Phone:813-938-4119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS002330L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA030018Medicare ID - Type UnspecifiedPROVIDER NUMBER