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Individual

BRUCE GRAHAM DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
400 EL CAMINO DR, #210, CYPRESS GARDENS, FL 33884-1697
(863) 232-9922
Mailing address
400 EL CAMINO DR, #210, CYPRESS GARDENS, FL 33884-1697
(863) 232-9922

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP2832442
FL

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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