Provider Demographics
NPI:1184644379
Name:BRAUN, STEFFAN B (PHARM D)
Entity Type:Individual
Prefix:
First Name:STEFFAN
Middle Name:B
Last Name:BRAUN
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 1:7160 W 20TH AVE STE M129
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5535
Mailing Address - Country:US
Mailing Address - Phone:305-663-3332
Mailing Address - Fax:305-665-1150
Practice Address - Street 1:7160 W 20TH AVE STE M129
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5535
Practice Address - Country:US
Practice Address - Phone:305-663-3332
Practice Address - Fax:305-665-1150
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4289850001Medicare ID - Type UnspecifiedMEDICARE # PHARMACY