Provider Demographics
NPI:1932429826
Name:BECKLES, EDWARD BENJAMIN (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:BENJAMIN
Last Name:BECKLES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 SALT CLAY CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6635
Mailing Address - Country:US
Mailing Address - Phone:813-907-8029
Mailing Address - Fax:
Practice Address - Street 1:4158 ROWAN RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6116
Practice Address - Country:US
Practice Address - Phone:727-372-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS30937OtherPHARMACIST