Provider Demographics
NPI:1255600151
Name:LAMBERTSON, RYAN JOSEPH
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JOSEPH
Last Name:LAMBERTSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TAMPA GENERAL CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3601
Mailing Address - Country:US
Mailing Address - Phone:813-660-6046
Mailing Address - Fax:813-844-1922
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-660-6046
Practice Address - Fax:813-844-1922
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT12615183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician