Individual provider Active NPI

Alex Lecklitner, PHARMD

  • Pharmacist
  • Plant City, FL
National Provider Identifier
1417563131
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS61547 Issued in FL
Practice address
2202 James L Redman Pkwy
Plant City, FL 33563-7107
Phone
(813) 659-1040
NPI assigned
Sep 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS61547 FL Primary

Addresses

Primary practice location

2202 James L Redman Pkwy
Plant City, FL 33563-7107

Mailing address

4310 W Spruce St Unit 411
Tampa, FL 33607-4268
Phone (918) 230-9001

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS61547FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Sep 20, 2020 Accepting new patients
Publix Super Markets Inc PastSince Sep 20, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1417563131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 W SPRUCE ST UNIT 411",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336074268",
            "telephone_number": "918-230-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 JAMES L REDMAN PKWY",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637107",
            "telephone_number": "813-659-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECKLITNER",
        "first_name": "ALEX",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS61547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.