Provider Demographics
NPI:1124038435
Name:BRANCH, DINA LINN (RPH CPH)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:LINN
Last Name:BRANCH
Suffix:
Gender:F
Credentials:RPH CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HICKORY LOOP WAY
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472
Mailing Address - Country:US
Mailing Address - Phone:352-629-8080
Mailing Address - Fax:352-629-2121
Practice Address - Street 1:1091 SW 6TH AV
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:352-629-8080
Practice Address - Fax:352-629-2121
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29713183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist