Provider Demographics
NPI:1316126469
Name:JESUS E LINARES MD PA
Entity type:Organization
Organization Name:JESUS E LINARES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LINARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-480-5700
Mailing Address - Street 1:13155 SW 42ND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3428
Mailing Address - Country:US
Mailing Address - Phone:305-480-5700
Mailing Address - Fax:305-649-7609
Practice Address - Street 1:13155 SW 42ND ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3428
Practice Address - Country:US
Practice Address - Phone:305-480-5700
Practice Address - Fax:305-649-7609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00695612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263874600Medicaid
FLK4209Medicare PIN
FL263874600Medicaid