Healthcare Provider Details

I. General information

NPI: 1306719117
Provider Name (Legal Business Name): LINDA BWANA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6936 MEDICAL VIEW LN
ZEPHYRHILLS FL
33542-6602
US

IV. Provider business mailing address

25403 SADDLEHORN WAY
LAND O LAKES FL
34639-9011
US

V. Phone/Fax

Practice location:
  • Phone: 813-999-1516
  • Fax: 813-441-8519
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNONE
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: