Provider Demographics
NPI:1497030787
Name:CARON, DOUGLAS EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:EUGENE
Last Name:CARON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4601 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2901
Mailing Address - Country:US
Mailing Address - Phone:561-841-8658
Mailing Address - Fax:561-841-8943
Practice Address - Street 1:4601 BROADWAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2901
Practice Address - Country:US
Practice Address - Phone:561-841-8658
Practice Address - Fax:561-841-8943
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist