Provider Demographics
NPI:1275241721
Name:LEVITES, RICHARD G (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:LEVITES
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 1:435 E ROSSETTI DR # A
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3581
Mailing Address - Country:US
Mailing Address - Phone:224-829-4648
Mailing Address - Fax:
Practice Address - Street 1:5250 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3225
Practice Address - Country:US
Practice Address - Phone:947-924-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist