Provider Demographics
NPI:1063792794
Name:ADAMS, BRUCE DAVID (RPH)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:DAVID
Last Name:ADAMS
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 1:3529 E SILVER SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6403
Mailing Address - Country:US
Mailing Address - Phone:352-622-5298
Mailing Address - Fax:352-622-4268
Practice Address - Street 1:3529 E SILVER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6403
Practice Address - Country:US
Practice Address - Phone:352-622-5298
Practice Address - Fax:352-622-4268
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS019021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist