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Individual

DR. LINDA LEE CIVERCHIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
333 LAS OLAS WAY 210, FORT LAUDERDALE, FL 33301-2363
(954) 235-3220
(954) 523-5429
Mailing address
333 LAS OLAS WAY APT 210, FORT LAUDERDALE, FL 33301-2374
(954) 235-3220
(954) 523-5429

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 39279
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME 39279
MEDICAL LICENSE
FL
Enumeration date
03/20/2013
Last updated
05/10/2013
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