NPIMap

Organization Active NPI

Praetorian RX LLC

  • Clinic/Center
  • Tampa, FL
National Provider Identifier
1699040055
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRAETORIAN RX LLC
Practice address
20429 Autumn Fern Ave
Tampa, FL 33647-2967
Phone
(186) 623-2877
NPI assigned
Mar 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Authorized official

Name
Dr. Kenneth Dewayne Lanier, PHARMD
Title
President
Phone
(813) 929-0778

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

20429 Autumn Fern Ave
Tampa, FL 33647-2967

Mailing address

20429 Autumn Fern Ave
Tampa, FL 33647-2967
Phone (186) 623-2877

National Provider Directory

National Provider Directory
Tax ID family
Praetorian RX LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332115200000",
    "number": "1699040055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20429 AUTUMN FERN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472967",
            "telephone_number": "186-623-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20429 AUTUMN FERN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472967",
            "telephone_number": "186-623-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAETORIAN RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-929-0778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.