Provider Demographics
NPI:1629833603
Name:PERMUY, LINDA R
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:PERMUY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 S GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33875-5847
Mailing Address - Country:US
Mailing Address - Phone:856-386-6040
Mailing Address - Fax:863-382-9482
Practice Address - Street 1:7205 S GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-5847
Practice Address - Country:US
Practice Address - Phone:856-386-6040
Practice Address - Fax:863-382-9482
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5260400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse