Provider Demographics
NPI:1982209961
Name:STEWART, NATALIE MELISSA (RPH)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:MELISSA
Last Name:STEWART
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 1:1600 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6346
Mailing Address - Country:US
Mailing Address - Phone:954-921-7747
Mailing Address - Fax:954-926-7747
Practice Address - Street 1:1600 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6346
Practice Address - Country:US
Practice Address - Phone:954-921-7747
Practice Address - Fax:954-926-7747
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLQ2P3S53932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist