Provider Demographics
NPI:1447654173
Name:BUEHNER, BRETT (RPH)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BUEHNER
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 1:175 MAIN ST UNIT 5917
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32540-7814
Mailing Address - Country:US
Mailing Address - Phone:850-376-6777
Mailing Address - Fax:
Practice Address - Street 1:853 HARBOR BLVD
Practice Address - Street 2:DESTIN
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2709
Practice Address - Country:US
Practice Address - Phone:850-212-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist