Provider Demographics
NPI:1285246207
Name:BORNSTEIN, DAVID BARRY (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BARRY
Last Name:BORNSTEIN
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 1:6967 KEVIN WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8701
Mailing Address - Country:US
Mailing Address - Phone:561-388-1092
Mailing Address - Fax:
Practice Address - Street 1:6967 KEVIN WAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-8701
Practice Address - Country:US
Practice Address - Phone:561-388-1092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist