Provider Demographics
NPI:1154542553
Name:MARINO, LINDA CANCELA (DIPL AC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CANCELA
Last Name:MARINO
Suffix:
Gender:F
Credentials:DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 IMMOKALEE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1407
Mailing Address - Country:US
Mailing Address - Phone:239-961-3330
Mailing Address - Fax:206-203-1186
Practice Address - Street 1:2180 IMMOKALEE RD STE 305
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1407
Practice Address - Country:US
Practice Address - Phone:239-961-3330
Practice Address - Fax:206-203-1186
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP-2079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35-2248040Medicare UPIN