Individual
MRS. LINDA MARIE BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
593 ALBANY PL, LONGWOOD, FL 32779-2264
(407) 782-3628
Mailing address
593 ALBANY PL, LONGWOOD, FL 32779-2264
(407) 782-3628
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA12516
FL
Other
Enumeration date
04/04/2007
Last updated
07/24/2016
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