Provider Demographics
NPI:1063495208
Name:WARE, LINDA J (NP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:WARE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8625 SW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-9444
Mailing Address - Country:US
Mailing Address - Phone:352-873-2305
Mailing Address - Fax:
Practice Address - Street 1:10831 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-9345
Practice Address - Country:US
Practice Address - Phone:352-873-3800
Practice Address - Fax:352-873-4800
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9291202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1063495208Medicare UPIN
CO1063495208Medicare UPIN