Provider Demographics
NPI:1114445566
Name:DESDUNES, PASCAL
Entity Type:Individual
Prefix:
First Name:PASCAL
Middle Name:
Last Name:DESDUNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5507
Mailing Address - Country:US
Mailing Address - Phone:727-447-3188
Mailing Address - Fax:727-447-5144
Practice Address - Street 1:703 COURT ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5507
Practice Address - Country:US
Practice Address - Phone:727-447-3188
Practice Address - Fax:727-447-5144
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist