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General NPI Number Information
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NPI Number | 1265167803
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Entity Type | Individual
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Provider Name | SEAN MARTIN LITTLE NP
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Gender | Male
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 14000 FIVAY RD
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City | HUDSON
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State | FL
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Zip | 34667-7103
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Country | US
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Telephone | 727-869-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 COVINGTON DR
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City | HOLIDAY
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State | FL
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Zip | 34691-2521
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Country | US
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Telephone | 727-272-2098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11020851
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License Number State | FL
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