MEDICARE: JESSICA L HUFF PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS41738	FL

General Provider Information

NPI Number	:	1194364810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L HUFF PHARMD

Provider Business Mailing Address
First Line	:	545 PINE ISLAND RD
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-3764
Country	:	US
Telephone Number	:	239-997-3131
Fax Number	:	239-997-2244

Provider Business Practice Location Address
First Line	:	545 PINE ISLAND RD
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-3764
Country	:	US
Telephone Number	:	239-997-3131
Fax Number	:	239-997-2244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2019
Last Update Date	:	12/27/2019

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