Ms Lutz LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH31405 Issued in FL

Legal business name

MS LUTZ LLC

Practice address

16142 Flight Path Dr
Brooksville, FL 34604-6845

Phone

(561) 543-4440

Fax

(888) 891-1847

NPI assigned

May 14, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ryan Goodkin

Title

Owner

Phone

(561) 208-1097

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1033609227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16142 FLIGHT PATH DR",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346046845",
            "telephone_number": "561-543-4440",
            "fax_number": "888-891-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16142 FLIGHT PATH DR",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346046845",
            "telephone_number": "561-543-4440",
            "fax_number": "888-891-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS LUTZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "GOODKIN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-208-1097"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH31405",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn D Moulton-Gray, ARNP
• Mowaffak Atfeh MD PA
• Bryan T Moynihan, P.A.C.
• Daniel P Moynihan, M.D.
• Basappa Mruthyunjaya, DDS
• Tabitha E Muchler, ARNP
• Sean Lee Muffley, ARNP-FNP
• Abdullah Azzam Muftah
• Azzam Muftah, M.D.
• Sierra Jo Muilenburg-Alvarez, APRN

• Pharmacy in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.