Provider Demographics
NPI:1851610133
Name:BURNS-KLEIN, BETH A (RPH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:BURNS-KLEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 S HWY 27
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-5383
Mailing Address - Country:US
Mailing Address - Phone:352-394-8029
Mailing Address - Fax:352-394-8317
Practice Address - Street 1:4400 S HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-5383
Practice Address - Country:US
Practice Address - Phone:352-394-8029
Practice Address - Fax:352-394-8317
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23887183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist