Provider Demographics
NPI:1477890515
Name:REPPEL, PATRICK TERRANCE
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:TERRANCE
Last Name:REPPEL
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 1:9900 ALT A1A
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4903
Mailing Address - Country:US
Mailing Address - Phone:561-624-1183
Mailing Address - Fax:
Practice Address - Street 1:9900 ALT A1A
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4903
Practice Address - Country:US
Practice Address - Phone:561-624-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist