Provider Demographics
NPI:1396188843
Name:HUBER, DON R
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:R
Last Name:HUBER
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 1:620 BRIARWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4784
Mailing Address - Country:US
Mailing Address - Phone:724-840-0753
Mailing Address - Fax:239-530-7280
Practice Address - Street 1:620 BRIARWOOD BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4784
Practice Address - Country:US
Practice Address - Phone:724-840-0753
Practice Address - Fax:239-530-7280
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040957L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP040957LOtherNABP # 521671