David Beauregard
Individual provider Active NPI Pharmacist · Okeechobee, FL
NPI 1326322165 · NPPES record last updated Sep 28, 2011
Key facts
- NPI
- 1326322165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS43207 (FL)
- Practice address
- 100 NW Park St
Okeechobee, FL 34972-4143 - Phone
- (863) 357-1754
- NPI assigned
- Sep 28, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS43207 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS43207 | FL | Yes |
Addresses
Primary practice location
100 NW Park St
Okeechobee, FL 34972-4143
Mailing address
901 SE 15TH St
Okeechobee, FL 34974-2419
Other providers in Okeechobee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.