Provider Demographics
NPI:1013017896
Name:HEDRICK, LINDA SUSAN (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SUSAN
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:SUSAN
Other - Last Name:ZANGRANDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:5912 BAYVIEW CIR S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3930
Mailing Address - Country:US
Mailing Address - Phone:727-343-2175
Mailing Address - Fax:
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist