Provider Demographics
NPI:1831436856
Name:LE FEVRE, KATE STULTZ (PHARMD)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:STULTZ
Last Name:LE FEVRE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 N GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8999
Mailing Address - Country:US
Mailing Address - Phone:407-681-3191
Mailing Address - Fax:
Practice Address - Street 1:4000 N GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8999
Practice Address - Country:US
Practice Address - Phone:407-681-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist