Provider Demographics
NPI:1346528940
Name:LITTLE, STEPHEN JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAMES
Last Name:LITTLE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12528 SW 121ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5171
Mailing Address - Country:US
Mailing Address - Phone:305-582-6343
Mailing Address - Fax:954-389-5470
Practice Address - Street 1:1601 TOWN CENTER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-349-6551
Practice Address - Fax:954-389-5470
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2939171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist