Provider Demographics
NPI:1083986632
Name:HAWKES, MICHAEL (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:HAWKES
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W THATCH PALM CIR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7174
Mailing Address - Country:US
Mailing Address - Phone:954-895-9483
Mailing Address - Fax:
Practice Address - Street 1:95 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5117
Practice Address - Country:US
Practice Address - Phone:561-743-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-29
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist