Provider Demographics
NPI:1164864567
Name:BEZICK, ROBERT J JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:BEZICK
Suffix:JR
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 1:683 NW GAREFOWL ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32331-5059
Mailing Address - Country:US
Mailing Address - Phone:850-464-8866
Mailing Address - Fax:
Practice Address - Street 1:683 NW GAREFOWL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:FL
Practice Address - Zip Code:32331-5059
Practice Address - Country:US
Practice Address - Phone:850-464-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS029326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist