Provider Demographics
NPI:1891065355
Name:DUARTE, BRUNO (PHARMD)
Entity type:Individual
Prefix:
First Name:BRUNO
Middle Name:
Last Name:DUARTE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LITTLE FLOWER CT
Mailing Address - Street 2:UNIT 205
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2465
Mailing Address - Country:US
Mailing Address - Phone:401-793-6732
Mailing Address - Fax:
Practice Address - Street 1:1534 CAPE CORAL PKWY W
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6953
Practice Address - Country:US
Practice Address - Phone:239-541-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist