Provider Demographics
NPI:1174549398
Name:HAUGHEY, BRUCE HARWOOD (MBCHB MS FACS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:HARWOOD
Last Name:HAUGHEY
Suffix:
Gender:M
Credentials:MBCHB MS FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 E BAREFOOT PL FL 32963
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-4548
Mailing Address - Country:US
Mailing Address - Phone:314-440-1415
Mailing Address - Fax:
Practice Address - Street 1:1431 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6500
Practice Address - Country:US
Practice Address - Phone:352-401-1000
Practice Address - Fax:352-401-1092
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1J88207Y00000X
FLME126033207YX0905X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO015010206Medicaid
IL$$$$$$$$$Medicaid
MO015010206Medicare PIN
IL$$$$$$$$$Medicaid