Provider Demographics
NPI:1609898626
Name:LINARES, EDITH LUZ (MD)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:LUZ
Last Name:LINARES
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 1:200 HENRY CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5720
Mailing Address - Country:US
Mailing Address - Phone:504-897-2753
Mailing Address - Fax:
Practice Address - Street 1:3321 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3680
Practice Address - Country:US
Practice Address - Phone:504-468-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07446R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1373303Medicaid
MS00118153Medicaid
MS00118153Medicaid
D04228Medicare UPIN
LA1373303Medicaid