Provider Demographics
NPI:1477638096
Name:MCCALL, BRUCE BENJAMIN JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:BENJAMIN
Last Name:MCCALL
Suffix:JR
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 1:482 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-6002
Mailing Address - Country:US
Mailing Address - Phone:850-997-8792
Mailing Address - Fax:850-514-2916
Practice Address - Street 1:482 COOPER RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-6002
Practice Address - Country:US
Practice Address - Phone:850-997-8792
Practice Address - Fax:850-514-2916
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS19928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist