Provider Demographics
NPI:1083900104
Name:HOWARD, ROBERT STEPHEN JR
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:HOWARD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 S US HIGHWAY 17/92
Mailing Address - Street 2:T-0898
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3290
Mailing Address - Country:US
Mailing Address - Phone:407-830-6363
Mailing Address - Fax:497-830-6363
Practice Address - Street 1:4410 S US HIGHWAY 17/92
Practice Address - Street 2:T-0898
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3290
Practice Address - Country:US
Practice Address - Phone:407-830-6363
Practice Address - Fax:497-830-6363
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS20484OtherPHARMACIST LICENSE NUMBER