Individual
DR. BRUCE V OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10000 SW INNOVATION WAY, PORT ST LUCIE, FL 34987-2111
(954) 345-8100
Mailing address
383 SE MULBERRY WAY, PORT ST LUCIE, FL 34984-2310
(850) 865-2644
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME84932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265032100
—
FL
Enumeration date
12/13/2005
Last updated
06/07/2023
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