Provider Demographics
NPI:1508345463
Name:HANG, STEPHANIE MEI
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MEI
Last Name:HANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 PAUL J DOHERTY PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8893
Mailing Address - Country:US
Mailing Address - Phone:239-340-7735
Mailing Address - Fax:
Practice Address - Street 1:13121 PAUL J DOHERTY PKWY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8893
Practice Address - Country:US
Practice Address - Phone:239-340-7735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist