Individual
LINDA DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4305 SHADOW WOOD LN, WINTER HAVEN, FL 33880-1525
(863) 978-8726
(863) 978-1789
Mailing address
PO BOX 159, EAGLE LAKE, FL 33839-0159
(863) 978-8726
(863) 978-1789
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
689272896
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689272896
—
FL
05
—
689272898
—
FL
Enumeration date
11/30/2010
Last updated
11/30/2010
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