Luther V Laite IV, PHARM.D. – Pharmacist

Key facts

NPI: 1790070100
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: PS42655 (FL)
Practice address: 3500 Reef PL
Malabar, FL 32950-4631
Phone: (321) 749-2989
NPI assigned: Jun 14, 2011
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Pharmacy

State licenses

License	State	Type	Specialty
PS42655	FL	MD	Pharmacist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	PS42655	FL	Yes

Addresses

Primary practice location

3500 Reef PL
Malabar, FL 32950-4631

Mailing address

3500 Reef PL
Malabar, FL 32950-4631
Phone (321) 749-2989

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 14, 2011.

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1790070100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 REEF PL",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "329504631",
            "telephone_number": "321-749-2989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 REEF PL",
            "city": "MALABAR",
            "state": "FL",
            "postal_code": "329504631",
            "telephone_number": "321-749-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAITE",
        "first_name": "LUTHER",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malabar, FL

All providers in Malabar, FL · Pharmacist in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.