Provider Demographics
NPI:1912225046
Name:BECKMAN, LINDA LEE (PTA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7927 STATE ROAD 52
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6783
Mailing Address - Country:US
Mailing Address - Phone:727-378-8586
Mailing Address - Fax:727-378-8587
Practice Address - Street 1:7927 STATE ROAD 52
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6783
Practice Address - Country:US
Practice Address - Phone:727-378-8586
Practice Address - Fax:727-378-8587
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20249225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant