Provider Demographics
NPI:1558586735
Name:KNUEVEN, JAMES HOWARD (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HOWARD
Last Name:KNUEVEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 TREASURE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-9204
Mailing Address - Country:US
Mailing Address - Phone:352-314-0040
Mailing Address - Fax:
Practice Address - Street 1:1103 W NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-3949
Practice Address - Country:US
Practice Address - Phone:352-787-0593
Practice Address - Fax:352-787-0571
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist