Provider Demographics
NPI:1649437484
Name:O'LENIC, KATHLEEN SUSAN (RPH)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:SUSAN
Last Name:O'LENIC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26757 HAVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-8509
Mailing Address - Country:US
Mailing Address - Phone:813-532-4357
Mailing Address - Fax:
Practice Address - Street 1:5100 W LEMON ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1111
Practice Address - Country:US
Practice Address - Phone:813-463-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 34912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist