Healthcare Provider Details

I. General information

NPI: 1770188971
Provider Name (Legal Business Name): CATHY STEVENS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3294 GREENWALD WAY N
KISSIMMEE FL
34741-0728
US

IV. Provider business mailing address

1038 LAKE BERKLEY DR
KISSIMMEE FL
34746-6127
US

V. Phone/Fax

Practice location:
  • Phone: 800-891-3040
  • Fax:
Mailing address:
  • Phone: 772-475-1463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS52164
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS52164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: