Healthcare Provider Details

I. General information

NPI: 1265352355
Provider Name (Legal Business Name): JAKOB MATTHEW MONTEMURNO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19390 CORTEZ BLVD
BROOKSVILLE FL
34601-3041
US

IV. Provider business mailing address

7036 MAIDSTONE CT
NEW PORT RICHEY FL
34653-5600
US

V. Phone/Fax

Practice location:
  • Phone: 352-796-2928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: