Provider Demographics
NPI:1588653471
Name:BRUNO, STEPHEN M (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:BRUNO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14207 HAMPSHIRE BAY CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5900
Mailing Address - Country:US
Mailing Address - Phone:407-654-4754
Mailing Address - Fax:407-654-4754
Practice Address - Street 1:14207 HAMPSHIRE BAY CIR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5900
Practice Address - Country:US
Practice Address - Phone:407-654-4754
Practice Address - Fax:407-654-4754
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 31128183500000X
GARPH 018310183500000X
FLPU 4888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist