Provider Demographics
NPI:1760159479
Name:STEAKIN, TARA LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:LYNN
Last Name:STEAKIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 MLK ST N APT 110
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-2310
Mailing Address - Country:US
Mailing Address - Phone:570-242-7401
Mailing Address - Fax:
Practice Address - Street 1:PUBLIX CORPORATE PKWY
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-3381
Practice Address - Country:US
Practice Address - Phone:863-688-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist