Provider Demographics
NPI:1801179221
Name:DUNBAR, STEPHANIE T (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:T
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 SW PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-5044
Mailing Address - Country:US
Mailing Address - Phone:772-878-6353
Mailing Address - Fax:772-878-4967
Practice Address - Street 1:280 SW PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5044
Practice Address - Country:US
Practice Address - Phone:772-878-6353
Practice Address - Fax:772-878-4967
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0033426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist