Provider Demographics
NPI:1750924361
Name:STEWART, MICHAEL HAROLD (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HAROLD
Last Name:STEWART
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 1:5242 HALTATA CT
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4365
Mailing Address - Country:US
Mailing Address - Phone:727-514-0859
Mailing Address - Fax:727-264-5223
Practice Address - Street 1:8745 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4947
Practice Address - Country:US
Practice Address - Phone:727-264-5224
Practice Address - Fax:727-264-5223
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0023540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist