Provider Demographics
NPI:1568794402
Name:GEORGE, STEPHEN (PHARMD, MS, RPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PHARMD, MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3304
Mailing Address - Country:US
Mailing Address - Phone:813-983-1500
Mailing Address - Fax:813-983-1501
Practice Address - Street 1:6285 EAST FOWLER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-3304
Practice Address - Country:US
Practice Address - Phone:813-983-1500
Practice Address - Fax:813-983-1501
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL309001835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist