1205136405 NPI number — LINDA D. BINDA, D.C., P.A.

Table of content: (NPI 1205136405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205136405 NPI number — LINDA D. BINDA, D.C., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINDA D. BINDA, D.C., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205136405
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1639 GEORGIA ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM BAY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32907-2568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-726-3917
Provider Business Mailing Address Fax Number:
321-729-9728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1639 GEORGIA ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM BAY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32907-2568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-726-3917
Provider Business Practice Location Address Fax Number:
321-729-9728
Provider Enumeration Date:
10/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BINDA
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
CHIROPRACTOR/P, VP, SEC, TRES.
Authorized Official Telephone Number:
321-726-3917

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 381297900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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