Provider Demographics
NPI:1306510375
Name:BISHOP, STEPHANIE R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:R
Last Name:BISHOP
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 1:462 MULBERRY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4531
Mailing Address - Country:US
Mailing Address - Phone:954-649-5645
Mailing Address - Fax:
Practice Address - Street 1:6800 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-4611
Practice Address - Country:US
Practice Address - Phone:954-649-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS54812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist