Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT5710 | FL |
NPI | 1043783988 |
---|---|
Provider Name | Michael J Linkovich |
First Address | Delray Beach, FL 33484-6409 |
Second Address | Delray Beach, FL 33484-6409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2019 |
Last Update Date | 03/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PT5710 | STATE LICENSE (01) | FL |