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General NPI Number Information
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NPI Number | 1750664496
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Entity Type | Individual
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Provider Name | BRYAN THOMAS NETTI PHARM D, LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1602 OAKFIELD DR STE 205
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City | BRANDON
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State | FL
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Zip | 33511-0827
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Country | US
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Telephone | 518-366-8809
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Fax |
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Provider Business Mailing Address
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Address Line | 201 W LAUREL ST APT 708
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City | TAMPA
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State | FL
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Zip | 33602-2936
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Country | US
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Telephone | 518-366-8809
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28703
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 101078
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License Number State | NY
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