Provider Demographics
NPI:1861696775
Name:BLAND, LINDA INEZ (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:INEZ
Last Name:BLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:INEZ
Other - Last Name:BLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:606 OAK HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2184
Mailing Address - Country:US
Mailing Address - Phone:561-762-6991
Mailing Address - Fax:561-630-7981
Practice Address - Street 1:606 OAK HARBOUR DR
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2184
Practice Address - Country:US
Practice Address - Phone:561-762-6991
Practice Address - Fax:561-630-7981
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62663207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF60735Medicare UPIN