Basic Information
| Provider Information | |||||||||
| NPI: | 1861475717 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINBERG | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4590 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344784590 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525099900 | ||||||||
| FaxNumber: | 3523872584 | ||||||||
| Practice Location | |||||||||
| Address1: | 2955 SE 3RD CT | ||||||||
| Address2: | FLORIDA MEDICAL ASSOCIATES | ||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344710441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525099900 | ||||||||
| FaxNumber: | 3523872584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2005 | ||||||||
| LastUpdateDate: | 11/08/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 217492 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME92077 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2023440 | 05 | MA | MEDICAID |