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General NPI Number Information
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NPI Number | 1417146861
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Entity Type | Individual
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Provider Name | PAUL LEON GARNEAU R.PH.,
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Gender | Male
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 1517 HONOR CT
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-2036
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Country | US
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Telephone | 239-565-1734
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Fax |
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Provider Business Mailing Address
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Address Line | 9981 S HEALTHPARK DR
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City | FORT MYERS
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State | FL
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Zip | 33908-3618
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Country | US
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Telephone | 239-343-5100
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Fax | 239-985-3880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0025805
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | PS0025805
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License Number State | FL
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