Healthcare Provider Details

I. General information

NPI: 1538155254
Provider Name (Legal Business Name): STEPHANIE KLAUSING PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TECHNOLOGY PARK STE 155
LAKE MARY FL
32746-6297
US

IV. Provider business mailing address

1070 DEKLEVA DR
APOPKA FL
32712-1725
US

V. Phone/Fax

Practice location:
  • Phone: 877-453-4566
  • Fax:
Mailing address:
  • Phone: 407-814-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36017
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: