Healthcare Provider Details

I. General information

NPI: 1942137054
Provider Name (Legal Business Name): JAMES LETTERESE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4599 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442
US

IV. Provider business mailing address

4599 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-5215
  • Fax:
Mailing address:
  • Phone: 954-333-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS45701
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: