Provider Demographics
NPI:1700091253
Name:BENNETT, LYNN WILLIAMS (RPH)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:WILLIAMS
Last Name:BENNETT
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 1:5105 SW 95TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4192
Mailing Address - Country:US
Mailing Address - Phone:352-224-2450
Mailing Address - Fax:352-224-2451
Practice Address - Street 1:4343 NEWBERRY ROAD
Practice Address - Street 2:SUITE 9
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-224-2450
Practice Address - Fax:352-224-2451
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS17042183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist