MEDICARE: STEPHANIE SY

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	PS46440	FL

General Provider Information

NPI Number	:	1083996359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SY

Provider Business Mailing Address
First Line	:	9009 GREENBROOK CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-1926
Country	:	US
Telephone Number	:	407-920-5409
Fax Number	:

Provider Business Practice Location Address
First Line	:	9009 GREENBROOK CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-1926
Country	:	US
Telephone Number	:	407-920-5409
Fax Number	:

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

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	09/13/2011

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Directions to “ STEPHANIE SY ” Practice Location

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