Provider Demographics
NPI:1992286371
Name:LITTLER, BRYAN A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:A
Last Name:LITTLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 S US HIGHWAY 17/92 STE 181
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-2915
Mailing Address - Country:US
Mailing Address - Phone:407-831-2323
Mailing Address - Fax:
Practice Address - Street 1:3385 S US HIGHWAY 17/92 STE 181
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-2915
Practice Address - Country:US
Practice Address - Phone:407-831-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS58246OtherSTATE LICENSE