Provider Demographics
NPI:1639478977
Name:HOWARD, LARRY BYRON (RPH)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:BYRON
Last Name:HOWARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5931 BRICK CT STE 150
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9430
Mailing Address - Country:US
Mailing Address - Phone:407-557-2029
Mailing Address - Fax:407-557-2030
Practice Address - Street 1:5931 BRICK CT STE 150
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9430
Practice Address - Country:US
Practice Address - Phone:407-557-2029
Practice Address - Fax:407-557-2030
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32866OtherBOARD OF PHARMACY