Provider Demographics
NPI:1043749930
Name:LINARES VELANDIA, JUAN DAVID (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:DAVID
Last Name:LINARES VELANDIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1306
Mailing Address - Fax:937-522-7017
Practice Address - Street 1:3737 SOUTHERN BLVD STE 3000
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1262
Practice Address - Country:US
Practice Address - Phone:937-531-0200
Practice Address - Fax:937-531-0198
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.150488207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease