Healthcare Provider Details

I. General information

NPI: 1225437106
Provider Name (Legal Business Name): ASHLYNN AUTUMN JONES PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLYNN AUTUMN GEORGE PHARM.D.

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 E SUNRISE BLVD
FORT LAUDERDALE FL
33304-2324
US

IV. Provider business mailing address

1415 E SUNRISE BLVD
FORT LAUDERDALE FL
33304-2324
US

V. Phone/Fax

Practice location:
  • Phone: 954-888-8980
  • Fax: 954-888-8988
Mailing address:
  • Phone: 954-888-8980
  • Fax: 954-888-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS51211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: