Provider Demographics
NPI:1508900614
Name:SEGUINOT, PETER J III (RPH)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:SEGUINOT
Suffix:III
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 1:1520 RAMBLING OAKS LANE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720
Mailing Address - Country:US
Mailing Address - Phone:386-748-6842
Mailing Address - Fax:
Practice Address - Street 1:2701 S WOODLAND BLVD
Practice Address - Street 2:WINN DIXIE PHARMACY #2341
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7005
Practice Address - Country:US
Practice Address - Phone:386-943-9940
Practice Address - Fax:386-943-8649
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist