Provider Demographics
NPI:1770904583
Name:BOUSQUET, DENIS (RPH)
Entity type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:BOUSQUET
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9183 THE LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-1562
Mailing Address - Country:US
Mailing Address - Phone:239-594-9183
Mailing Address - Fax:
Practice Address - Street 1:9183 THE LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-1562
Practice Address - Country:US
Practice Address - Phone:239-594-9183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-20
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist