Provider Demographics
NPI:1831348333
Name:BOUQUET, LUC LEONEL (ARNP)
Entity type:Individual
Prefix:MR
First Name:LUC
Middle Name:LEONEL
Last Name:BOUQUET
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:LUC
Other - Middle Name:LEONEL
Other - Last Name:BOUQUET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:40100 HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5900
Mailing Address - Country:US
Mailing Address - Phone:337-609-8700
Mailing Address - Fax:337-262-7367
Practice Address - Street 1:1790 HIGHWAY A1A STE 205
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-5440
Practice Address - Country:US
Practice Address - Phone:321-221-7447
Practice Address - Fax:321-221-7448
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3360112363L00000X, 363LF0000X, 363LA2200X
FLARNP3360112363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily