Provider Demographics
NPI:1952686842
Name:STEELE, JON KELLY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:KELLY
Last Name:STEELE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2326
Mailing Address - Country:US
Mailing Address - Phone:352-597-7504
Mailing Address - Fax:352-597-7509
Practice Address - Street 1:4255 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2326
Practice Address - Country:US
Practice Address - Phone:352-597-7504
Practice Address - Fax:352-597-7509
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist