Provider Demographics
NPI:1861415465
Name:BINDA, LINDA DIANE (DC)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DIANE
Last Name:BINDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 GEORGIA ST NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-2568
Mailing Address - Country:US
Mailing Address - Phone:321-726-3917
Mailing Address - Fax:321-729-9728
Practice Address - Street 1:1639 GEORGIA ST NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2568
Practice Address - Country:US
Practice Address - Phone:321-726-3917
Practice Address - Fax:321-729-9728
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3812979-00Medicaid
FLU61775Medicare UPIN