MEDICARE: MICHELE L LENNOX 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	PU-5747	FL
2	183500000X	Pharmacist	PS-26259	FL

General Provider Information

NPI Number	:	1922000405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE L LENNOX PHARM.D.

Provider Business Mailing Address
First Line	:	5431 STAG THICKET LN
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-2525
Country	:	US
Telephone Number	:	727-743-7055
Fax Number	:

Provider Business Practice Location Address
First Line	:	3765 ULMERTON RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33762-4209
Country	:	US
Telephone Number	:	727-573-3383
Fax Number	:	727-572-5716

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

Provider Enumeration Date	:	08/13/2005
Last Update Date	:	11/24/2020

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