Provider Demographics
NPI:1174126213
Name:ROUSE, STEPHANIE SKRABUT
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SKRABUT
Last Name:ROUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 98TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-3044
Mailing Address - Country:US
Mailing Address - Phone:561-420-9838
Mailing Address - Fax:401-652-0816
Practice Address - Street 1:2575 98TH AVE
Practice Address - Street 2:ATTN: STEPHANIE ROUSE
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966
Practice Address - Country:US
Practice Address - Phone:561-420-9838
Practice Address - Fax:401-652-0816
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist