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General NPI Number Information
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NPI Number | 1558477406
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Entity Type | Individual
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Provider Name | LYLE DOUGLAS RIED RPH, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 101 SOUTH NEWELL DRIVE
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City | GAINESVILLE
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State | FL
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Zip | 32610-0496
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Country | US
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Telephone | 352-273-6259
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Fax | 352-273-6270
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Provider Business Mailing Address
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Address Line | 3412 NW 26TH TERRACE
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City | GAINESVILLE
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State | FL
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Zip | 32605-2206
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Country | US
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Telephone | 352-335-0089
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Fax | 352-273-6270
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00009487
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License Number State | WA
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