Individual
CASEY LINEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
842 SUNSET LAKE BLVD, SUITE 403, BLDG. B, VENICE, FL 34292-7551
(941) 684-3216
(941) 485-7677
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108085
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225577
WELLCARE
FL
01
—
1666744
CIGNA
FL
01
—
398592
AVMED
FL
01
—
5924852
AETNA
FL
01
—
P01374271
RR MEDICARE
FL
01
—
P1020766
FREEDOM
FL
01
—
P959325
OPTIMUM
FL
01
—
Y0N2U
BCBS
FL
Enumeration date
08/12/2014
Last updated
05/23/2023
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