Provider Demographics
NPI:1194934448
Name:LITTLE, MARTHA M (RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:M
Last Name:LITTLE
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4689 CARLTON GOLF DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8132
Mailing Address - Country:US
Mailing Address - Phone:561-504-6745
Mailing Address - Fax:561-641-9525
Practice Address - Street 1:4689 CARLTON GOLF DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33467-8132
Practice Address - Country:US
Practice Address - Phone:561-504-6745
Practice Address - Fax:561-641-9525
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS #210021835G0303X
FLPU #29431835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric