Provider Demographics
NPI:1649870718
Name:BASSETT, PETER BRADLEY (PHARM D)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:BRADLEY
Last Name:BASSETT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-1460
Mailing Address - Country:US
Mailing Address - Phone:229-403-7447
Mailing Address - Fax:
Practice Address - Street 1:35800 US HWY 27 N
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-3735
Practice Address - Country:US
Practice Address - Phone:863-422-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist