Healthcare Provider Details

I. General information

NPI: 1447865456
Provider Name (Legal Business Name): ANNA JAYNE HALL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3599 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442-9404
US

IV. Provider business mailing address

408 NE 6TH ST UNIT 102
FORT LAUDERDALE FL
33304-6400
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-5215
  • Fax:
Mailing address:
  • Phone: 850-814-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS61077
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: