Provider Demographics
NPI:1871588350
Name:BADILLO, LINDA J (MD)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:BADILLO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:RENAL HYPERTENSION CENTER
Mailing Address - Street 2:14134 NEPHRONE LANE
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667
Mailing Address - Country:US
Mailing Address - Phone:727-863-5418
Mailing Address - Fax:727-869-8626
Practice Address - Street 1:RENAL HYPERTENSION CENTER
Practice Address - Street 2:14134 NEPHRONE LANE
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667
Practice Address - Country:US
Practice Address - Phone:727-863-5418
Practice Address - Fax:727-869-8626
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME66669207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2504896OtherGHI
593068073OtherHUMANA
0004646644OtherAETNA
1488952OtherCIGNA
593068073OtherPCHS
PRO0018OtherQUALITY/DELTA
593068073OtherHUMANA MILITARY
818295OtherFIRST HEALTH
09597OtherWELLCARE
000002512762OtherPRINCIPAL
01243OtherUNIVERSAL
10501401OtherCITRUS HEALTH CARE
818295OtherCCN
1007ID#OtherOPTIMUM
214617OtherAVMED
FL376839200Medicaid
593068073OtherSOUTHCARE
593068073OtherBEECH STREET
593068073OtherPCHS
593068073OtherBEECH STREET