Provider Demographics
NPI:1518568484
Name:RITTMAN-BRYANT, GAYLA CHERESE
Entity Type:Individual
Prefix:
First Name:GAYLA
Middle Name:CHERESE
Last Name:RITTMAN-BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-3920
Mailing Address - Country:US
Mailing Address - Phone:850-691-0719
Mailing Address - Fax:850-691-0720
Practice Address - Street 1:513 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3920
Practice Address - Country:US
Practice Address - Phone:850-691-0719
Practice Address - Fax:850-691-0720
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist