Healthcare Provider Details

I. General information

NPI: 1750784310
Provider Name (Legal Business Name): LINDA LUMPKIN BECTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2014
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 S HIGHWAY 27
CLERMONT FL
34711-5349
US

IV. Provider business mailing address

4351 S HIGHWAY 27
CLERMONT FL
34711-5349
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-2915
  • Fax: 352-394-1784
Mailing address:
  • Phone: 352-394-2915
  • Fax: 352-394-1784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS23714
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: