Provider Demographics
NPI:1588872634
Name:DEWITTE, DEBBIE C
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:C
Last Name:DEWITTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:COPPOCK
Other - Last Name:DEWITTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9775 WHITEHALL ST
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-1627
Mailing Address - Country:US
Mailing Address - Phone:239-254-9671
Mailing Address - Fax:239-254-9671
Practice Address - Street 1:9775 WHITEHALL ST
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-1627
Practice Address - Country:US
Practice Address - Phone:239-254-9671
Practice Address - Fax:239-254-9671
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS18260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist