Provider Demographics
NPI:1083212658
Name:RICKS, BRITTANI (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:
Last Name:RICKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 CITRUS TOWER BLVD APT 8308
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6836
Mailing Address - Country:US
Mailing Address - Phone:904-534-0217
Mailing Address - Fax:
Practice Address - Street 1:820 OLD CAMP RD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5611
Practice Address - Country:US
Practice Address - Phone:352-391-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist