=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982209961
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE MELISSA STEWART RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2020
-----------------------------------------------------
Last Update Date | 11/30/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 S FEDERAL HWY
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33020-6346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-921-7747
-----------------------------------------------------
Fax | 954-926-7747
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1600 S FEDERAL HWY
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33020-6346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-921-7747
-----------------------------------------------------
Fax | 954-926-7747
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | Q2P3S53932
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------