Provider Demographics
NPI:1922000405
Name:LENNOX, MICHELE L (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:L
Last Name:LENNOX
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 1:5431 STAG THICKET LN
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2525
Mailing Address - Country:US
Mailing Address - Phone:727-743-7055
Mailing Address - Fax:
Practice Address - Street 1:3765 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-4209
Practice Address - Country:US
Practice Address - Phone:727-573-3383
Practice Address - Fax:727-572-5716
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-13
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU-5747183500000X
FLPS-26259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist