MEDICARE: DR. STEPHANIE TEARS PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS49319	FL

General Provider Information

NPI Number	:	1770821662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE TEARS PHARM.D.

Provider Business Mailing Address
First Line	:	3319 CYPRESS LEGENDS CIR APT 733
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-5529
Country	:	US
Telephone Number	:	239-293-4026
Fax Number	:

Provider Business Practice Location Address
First Line	:	3306 BONITA BEACH RD
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-4174
Country	:	US
Telephone Number	:	239-495-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

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