Provider Demographics
NPI:1851686489
Name:BECKER, CLIFF
Entity type:Individual
Prefix:
First Name:CLIFF
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3353
Mailing Address - Country:US
Mailing Address - Phone:954-366-2135
Mailing Address - Fax:954-366-2145
Practice Address - Street 1:4400 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33073-3353
Practice Address - Country:US
Practice Address - Phone:954-366-2135
Practice Address - Fax:954-366-2145
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist