Provider Demographics
NPI:1790862209
Name:BRUMER, DANIEL S (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:S
Last Name:BRUMER
Suffix:
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:ONE MAIN ST
Mailing Address - Street 2:# 107
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469
Mailing Address - Country:US
Mailing Address - Phone:561-741-8222
Mailing Address - Fax:561-741-8220
Practice Address - Street 1:ONE MAIN ST
Practice Address - Street 2:# 107
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469
Practice Address - Country:US
Practice Address - Phone:561-741-8222
Practice Address - Fax:561-741-8220
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist