Provider Demographics
NPI:1770702185
Name:RESHARD, LLOYD (FIT)
Entity type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:
Last Name:RESHARD
Suffix:
Gender:M
Credentials:FIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 DAHLQUIST DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539
Mailing Address - Country:US
Mailing Address - Phone:850-391-2536
Mailing Address - Fax:850-391-2533
Practice Address - Street 1:1989 CAPITAL CIR NE STE 9
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4476
Practice Address - Country:US
Practice Address - Phone:850-543-3920
Practice Address - Fax:850-391-2533
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist