Provider Demographics
NPI:1013413681
Name:ANNA L. BUCK, P.A.
Entity Type:Organization
Organization Name:ANNA L. BUCK, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC
Authorized Official - Phone:850-686-1979
Mailing Address - Street 1:5327 COMMERCIAL WAY STE C115
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1420
Mailing Address - Country:US
Mailing Address - Phone:352-597-5497
Mailing Address - Fax:352-597-1662
Practice Address - Street 1:5327 COMMERCIAL WAY STE C115
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1420
Practice Address - Country:US
Practice Address - Phone:352-597-5497
Practice Address - Fax:352-597-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)