Stephanie Rutledge Wallace, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS21192 Issued in FL

Practice address

2216 Hollywood Blvd
Hollywood, FL 33020-6702

Phone

(954) 926-2914

Fax

(954) 926-2957

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Stephanie Denise Rutledge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871516559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14480 SW 37TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273790",
            "telephone_number": "954-499-1713",
            "fax_number": "954-499-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206702",
            "telephone_number": "954-926-2914",
            "fax_number": "954-926-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "STEPHANIE",
        "middle_name": "RUTLEDGE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS21192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "RUTLEDGE",
            "middle_name": "DENISE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walif Aji MD PA
• Lenore E Walker, PSYCHOLOGIST
• Walkie Talkie Therapy Group, Inc
• Wallace Physical Therapy LLC (ResolveRx)
• Jocelyn Diane Wallace, PT, DPT
• Marlene Wallen, ARNP
• Priscilla Walters
• Wilson Christopher Walters, COTA
• Melissa Wandique
• Annie P Wang, D.O.

• Pharmacist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.