Provider Demographics
NPI:1053357632
Name:RICE, LINDA JO (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JO
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 2ND ST N UNIT 202
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3016
Mailing Address - Country:US
Mailing Address - Phone:727-580-8145
Mailing Address - Fax:
Practice Address - Street 1:COLLIER HEALTH SERVICES UNIV OF FL PEDIATR DENTAL CENT
Practice Address - Street 2:7505 GRAND LELY DRIVE
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113
Practice Address - Country:US
Practice Address - Phone:727-580-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME35590207L00000X, 207LP3000X
FLME0035590207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379876300Medicaid
FL31880ZMedicare ID - Type Unspecified
FL379876300Medicaid