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General NPI Number Information
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NPI Number | 1336749993
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Entity Type | Individual
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Provider Name | LINEAU VILSON JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2020
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Last Update Date | 10/31/2020
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Provider Practice Location Address
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Address Line | 3625 S FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8656
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Country | US
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Telephone | 561-600-3095
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Fax | 561-600-3089
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Provider Business Mailing Address
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Address Line | 8929 ALEXANDRA CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-6437
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Country | US
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Telephone | 561-235-8701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS50008
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License Number State | FL
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