Individual provider · NPI-1

Dr. Bruce V Ouellette, M.D.

Psychiatry & Neurology, Neurology · Port St Lucie, FL

NPI number1285619221

StatusActive

Last updated in NPPESJun 7, 2023

Details

NPI: 1285619221
Entity type: Individual (NPI-1)
Name: Dr. Bruce V Ouellette
Credential: M.D.
Sex: Male
Sole proprietor: No
Enumeration date: Dec 13, 2005
Certification date: Apr 17, 2023
Last updated: Jun 7, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2084N0400X	Psychiatry & Neurology, Neurology	ME84932	FL	Yes

Practice location

10000 Sw Innovation Way
Port St Lucie, FL 34987-2111

Phone 954-345-8100

Mailing address

383 Se Mulberry Way
Port St Lucie, FL 34984-2310

Phone 850-865-2644

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