Provider Demographics
NPI:1730875691
Name:LINARES, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:LINARES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 WHALEBONE BAY DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7428
Mailing Address - Country:US
Mailing Address - Phone:407-242-9424
Mailing Address - Fax:407-624-4212
Practice Address - Street 1:2649 WHALEBONE BAY DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7428
Practice Address - Country:US
Practice Address - Phone:407-242-9424
Practice Address - Fax:407-624-4212
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator