Provider Demographics
NPI:1144412800
Name:LINDER, WAYNE (RPH)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:
Last Name:LINDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 PEREGRINE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2369
Mailing Address - Country:US
Mailing Address - Phone:954-648-1438
Mailing Address - Fax:
Practice Address - Street 1:1932 WESTON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3214
Practice Address - Country:US
Practice Address - Phone:954-389-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS27675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist