Provider Demographics
NPI:1043318462
Name:PALET, LITZA IVETTE (RPT)
Entity Type:Individual
Prefix:
First Name:LITZA
Middle Name:IVETTE
Last Name:PALET
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:LITZA
Other - Middle Name:IVETTE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 S CONGRESS AVE
Mailing Address - Street 2:SUITE-13
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8424
Mailing Address - Country:US
Mailing Address - Phone:561-733-6665
Mailing Address - Fax:561-733-6663
Practice Address - Street 1:3800 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8424
Practice Address - Country:US
Practice Address - Phone:561-733-6665
Practice Address - Fax:561-733-6663
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL270101031156567183700000X
FLRPT28543183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043318462OtherNPI NUMBER
270101031156567OtherNATIONAL PHARMACY TECHNICIAN CERTIFICATION NUMBER
FLRPT28543OtherLICENSES NUMBER
FL103989000Medicaid
1043318462OtherNPI NUMBER