Provider Demographics
NPI:1336433606
Name:TUBBS, STEVEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:TUBBS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13711 S TAMIAMI TRL
Mailing Address - Street 2:T-0818
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-1649
Mailing Address - Country:US
Mailing Address - Phone:239-481-3755
Mailing Address - Fax:239-481-3755
Practice Address - Street 1:13711 S TAMIAMI TRL
Practice Address - Street 2:T-0818
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-1649
Practice Address - Country:US
Practice Address - Phone:239-481-3755
Practice Address - Fax:239-481-3755
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0030683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist