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General NPI Number Information
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NPI Number | 1841569001
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Entity Type | Individual
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Provider Name | MANUEL LITTLEFIELD
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Gender | Male
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Dates
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Enumeration Date | 12/17/2011
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Last Update Date | 12/17/2011
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Provider Practice Location Address
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Address Line | 1320 EXECUTIVE CENTER DR STE 302
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City | TALLAHASSEE
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State | FL
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Zip | 32301-5011
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Country | US
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Telephone | 850-877-7603
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Fax | 850-877-7482
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Provider Business Mailing Address
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Address Line | 6930 HANGING VINE WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32317-8517
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Country | US
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Telephone | 850-219-0557
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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 | PS23186
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License Number State | FL
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