Basic Information
Provider Information
NPI: 1235181553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINDQUIST
FirstName: TODD
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3434 HANCOCK BRIDGE PKWY
Address2: STE 301
City: NORTH FORT MYERS
State: FL
PostalCode: 339037094
CountryCode: US
TelephoneNumber: 8778563774
FaxNumber: 2395992612
Practice Location
Address1: 400 8TH ST N
Address2:  
City: NAPLES
State: FL
PostalCode: 341025519
CountryCode: US
TelephoneNumber: 2392621171
FaxNumber: 2392618491
Other Information
ProviderEnumerationDate: 05/16/2006
LastUpdateDate: 12/01/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000X38847MNN Allopathic & Osteopathic PhysiciansOtolaryngology 
207Y00000XME122818FLY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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