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Individual
LINDA BACO
Active
Individual
LINDA BACO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102870
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292355600
—
FL
01
—
300725
AVMED
FL
01
—
U7180A
MEDICARE
—
Enumeration date
05/04/2006
Last updated
05/19/2008
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