Provider Demographics
NPI:1164416392
Name:VANRIPER, BRADLEY WILLIAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:WILLIAM
Last Name:VANRIPER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 NW 35TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8120
Mailing Address - Country:US
Mailing Address - Phone:352-371-9782
Mailing Address - Fax:
Practice Address - Street 1:1170 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-5614
Practice Address - Country:US
Practice Address - Phone:352-380-0131
Practice Address - Fax:352-380-0223
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34850183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS34850OtherSTATE LICENSE NUMBER