Provider Demographics
NPI:1780359067
Name:LOWENKRON, STEPHEN L (RPH)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:LOWENKRON
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 1:13079 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2549
Mailing Address - Country:US
Mailing Address - Phone:305-761-6907
Mailing Address - Fax:
Practice Address - Street 1:3677 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8226
Practice Address - Country:US
Practice Address - Phone:239-243-9025
Practice Address - Fax:187-747-0972
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS12669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist