Active NPI
Robert Reedy III, CPHT
- Pharmacy Technician
- Lakeland, FL
National Provider Identifier
1053680397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- RPT19090
- Practice address
- 1704 Wayman St
Lakeland, FL 33815-4068 - Phone
- (863) 937-6692
- Fax
- (863) 937-6696
- NPI assigned
- Dec 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | RPT19090 | FL | Primary |
Addresses
Primary practice location
1704 Wayman St
Lakeland, FL 33815-4068
Mailing address
1704 Wayman St
Lakeland, FL 33815-4068
Phone (863) 937-6692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPT19090 | FL | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323907200000",
"number": "1053680397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1704 WAYMAN ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338154068",
"telephone_number": "863-937-6692",
"fax_number": "863-937-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 WAYMAN ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338154068",
"telephone_number": "863-937-6692",
"fax_number": "863-937-6696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEDY",
"first_name": "ROBERT",
"name_prefix": "Mrs.",
"name_suffix": "III",
"credential": "CPHT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-15",
"last_updated": "2011-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "FL",
"license": "RPT19090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.