Provider Demographics
NPI:1528660370
Name:FIORENTINO, LINDA ELIZABETH
Entity type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:ELIZABETH
Last Name:FIORENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PAGE ST
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2829
Mailing Address - Country:US
Mailing Address - Phone:330-931-7872
Mailing Address - Fax:
Practice Address - Street 1:625 PAGE ST
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2829
Practice Address - Country:US
Practice Address - Phone:330-931-7872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant